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Myocardial function in acute pancreatitis

K Ito, G Ramirez-Schon, P M Shah

    Annals of Surgery
    |July 1, 1981
    PubMed
    Summary
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    Acute pancreatitis causes an elevated cardiac index (CI) and myocardial depression, distinct from the hyperdynamic state in cirrhosis. Patients with pancreatitis can increase oxygen consumption with CI, unlike cirrhotics.

    Area of Science:

    • Cardiology
    • Gastroenterology
    • Critical Care Medicine

    Background:

    • Acute pancreatitis presents complex cardiopulmonary challenges.
    • Cirrhosis is known to induce a hyperdynamic hemodynamic state.

    Purpose of the Study:

    • To compare cardiopulmonary assessments in acute pancreatitis patients with normal subjects and cirrhotics.
    • To elucidate the distinct hemodynamic profiles of acute pancreatitis and cirrhosis.

    Main Methods:

    • Physiologic cardiopulmonary assessments were performed on 15 acute pancreatitis patients.
    • Data were compared with 61 assessments from normal postoperative patients and 113 from 41 cirrhotics.
    • Sarnoff curves were utilized to assess myocardial function.

    Main Results:

    Related Experiment Videos

    • Acute pancreatitis patients exhibited an elevated cardiac index (CI) not attributable to cirrhotic hyperdynamic state.
    • Myocardial depression was observed in acute pancreatitis (p < 0.03), absent in hyperdynamic cirrhotics.
    • Cirrhotics showed an inability to increase oxygen consumption with CI, unlike pancreatitis patients and normal subjects.

    Conclusions:

    • Acute pancreatitis is characterized by primary myocardial depression, with normal peripheral vasculature response.
    • The hemodynamic lesion in cirrhosis involves capillary-level arteriovenous shunting, impairing tissue perfusion.
    • Distinct pathophysiological mechanisms underlie the hemodynamic disturbances in acute pancreatitis and cirrhosis.