The role of natriuretic peptides in the management, outcomes and prognosis of sepsis and septic shock

RESUMO A sepse persiste como importante sobrecarga à saúde pública nos Estados Unidos e em todo o mundo. Com o crescente uso de tecnologias laboratoriais, tem se renovado o interesse na utilização de biomarcadores na sepse, para auxiliar em um processo mais preciso e direcionado para tomadas de decisão. Os peptídeos natriuréticos vem sendo c ada vez mais reconhecidos por seu papel que vai além da insuficiência cardíaca. Estes peptídeos estão comumente elevados em pacientes críticos que apresentam condições de disfunção cardiopulmonar e podem ter papel na identificação de pacientes com sepse e choque séptico. São poucos os dados disponíveis em relação ao papel destes biomarcadores no diagnóstico, no controle, nos desfechos e no prognóstico de pacientes sépticos. Esta revisão procura descrever o papel dos peptídeos natriuréticos na ressuscitação volêmica, no diagnóstico de disfunção ventricular, nos desf echos e no prognóstico de pacientes com sepse. Tem sido observado que o peptídeo natriurético tipo B (BNP) e o fragmento N-terminal do peptídeo natriurético tipo B (NT-proBNP) se associam com disfunção ventricular sistólica e diastólica, tanto esquerda quanto dire...
Source: Revista Brasileira de Terapia Intensiva - Category: Intensive Care Source Type: research

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Democratic White House contenders united in supporting the impeachment inquiry against Republican President Donald Trump at a debate on Wednesday that featured differences on policy details but few of the bitter attacks on one another that marked earlier encounters.
Source: Reuters: Health - Category: Consumer Health News Tags: healthNews Source Type: news
Publication date: Available online 20 November 2019Source: Indian Heart JournalAuthor(s): Shaimaa MostafaAbstractBackgroundFew studies have evaluated right ventricle systolic function in different categories of heart failure despite its effect on outcomes.Methods and resultssingle-centre, cross-sectional study included 150 patients, 50 patients in each category of HF: group I, preserved; group II, mid-range, group III reduced ejection fraction. Left ventricular systolic function was assessed by 3D echo, and right ventricular systolic function was assessed by fraction area change (FAC), tricuspid annular plane systolic excu...
Source: Indian Heart Journal - Category: Cardiology Source Type: research
Publication date: Available online 19 November 2019Source: Indian Heart JournalAuthor(s): Shamshad Alam, Sharad Chandra, Gaurav Chaudhary, Akhil Sharma, Monika Bhandhari, Pravesh Vishwakarma, Akshaya Pradhan, Rishi Sethi, Sudhanshu K. Dwivedi, Varun S. NarainAbstractBackgroundChemotherapy-induced cardiotoxicity constitutes subclinical myocardial dysfunction, arrhythmias, pericarditis, coronary vasospasm, significant symptomatic heart failure. Anthracyclines pose higher risk for long-term cardiac dysfunction, with increased incidences of morbidity and mortality. Hence, early detection of chemotherapy induced cardiac dysfunc...
Source: Indian Heart Journal - Category: Cardiology Source Type: research
CONCLUSION: Here we will briefly summarize the recent experimental and clinical progresses on myocardial mitochondrial morphology and function in sepsis, and discuss possible underlying mechanisms, as well as the comtemporary interventional options. PMID: 31284854 [PubMed - as supplied by publisher]
Source: Current Pharmaceutical Design - Category: Drugs & Pharmacology Authors: Tags: Curr Pharm Des Source Type: research
Publication date: Available online 11 April 2019Source: Chemico-Biological InteractionsAuthor(s): Liang-Chi Chen, Marthandam Asokan Shibu, Chung-Jung Liu, Chien-Kuo Han, Da-Tong Ju, Pei-Yu Chen, Vijaya Padma Viswanadha, Chao-Hung Lai, Wei-Wen Kuo, Chih-Yang HuangAbstractMyocardial fibrosis is a critical event during septic shock. Upregulation in the fibrosis signaling cascade proteins such as fibroblast growth factor (FGF), urokinase plasminogen activator (uPA), tissue plasminogen activator (tPA) and activation of matrix metalloproteinases (MMPs) are widely associated with the development of myocardial infarction, dilated ...
Source: Chemico Biological Interactions - Category: Biochemistry Source Type: research
Abstract Myocardial fibrosis is a critical event during septic shock. Upregulation in the fibrosis signaling cascade proteins such as fibroblast growth factor (FGF), urokinase plasminogen activator (uPA), tissue plasminogen activator (tPA) and activation of matrix metalloproteinases (MMPs) are widely associated with the development of myocardial infarction, dilated cardiomyopathy, cardiac fibrosis and heart failure. However, evidences suggest that the common upstream mediators of fibrosis cascade play little role in cardiac fibrosis induced by LPS; further, it is unknown if LPS directly triggers the expressions an...
Source: Chemico-Biological Interactions - Category: Molecular Biology Authors: Tags: Chem Biol Interact Source Type: research
While both sepsis-induced myocardial dysfunction (SIMD) and stress-induced cardiomyopathy (SICMP) are common in patients with sepsis, the pathogenesis of the 2 diseases is different, and they require different treatment strategies. Thus, we aimed to investigate risk factors and outcomes between the 2 diseases. This retrospective study enrolled patients diagnosed with sepsis or septic shock, admitted to intensive care unit via emergency department in Korea University Anam Hospital, and who underwent transthoracic echocardiography within the first 24 hours of admission. In all, 25 patients with SIMD and 27 patients with ...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Elevated plasma levels of stress hormones and catecholamines were found in patients with takotsubo cardiomyopathy (TC). To investigate the presence of circulating cardiodepressant factors, plasma samples were collected from 4 patients with TC, 3 with septic shock, 5 with acute systolic heart failure and 4 healthy controls and injected intraperitoneally in mice. Plasma injection from control subjects and TC patients had no effects on left ventricle ejection fraction (LVEF) whereas plasma from the other two groups induced a significant reduction in LVEF.
Source: Autonomic Neuroscience: Basic and Clinical - Category: Neuroscience Authors: Tags: Short Communication Source Type: research
Abstract Circulating cardiodepressant factors were found to mediate cardiac dysfunction in patients with sepsis and acute systolic heart failure. To investigate the presence of circulating cardiodepressant factors in patients with Takotsubo Cardiomyopathy (TC), plasma samples were collected from 4 patients with TC, 3 with septic shock, 5 with acute systolic heart failure and 4 healthy controls and injected intraperitoneally in mice. The cardiodepressant effects are measured with transthoracic echocardiography. Plasma injection from control and TC subjects had no effects on left ventricle ejection fraction (LVEF) w...
Source: Autonomic Neuroscience - Category: Neuroscience Authors: Tags: Auton Neurosci Source Type: research
A 34-year-old female was admitted with septic shock and disseminated intravascular coagulation syndrome caused by invasive pneumococcal infection. During hospitalization, she developed progressive respiratory failure caused by congestive heart failure. The low output syndrome progressed with reduced EF (20%) without LV dilatation. She was transferred to our hospital for the intensive therapy. After treatment with dobutamine, her symptom got better. Coronary angiogram did not reveal organic stenosis.
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Source Type: research
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