Acute reversible myocardial depression associated with sepsis.
A 30-year-old man was admitted to our hospital for left lobar pneumonia with septic shock. Acute left-sided heart failure became evident as sepsis developed. Echocardiography revealed diffuse severe hypokinesis of the left ventricle (LV) and a pulmonary artery catheter showed Forrester subset II hemodynamics. Along with amelioration of sepsis and decrease of the serum concentrations of tumor necrosis factor-alpha and interleukin-6, LV hypokinesis improved. It is suggested that the patient's heart failure may have been due to functional depression of myocardial contractility resulting from a direct effect of the cytokines towards the cardiomyocytes, the so-called "septic myocardial depression".
Kontani
Makoto
M
Department of Cardiology, Tsuruga Municipal Hospital, 1-6-60 Mishima-cho, Tsuruga, Fukui 914-8502.
Izumiya
Yoshiaki
Y
Shimizu
Miho
M
Yasuma
Keiichi
K
Inada
Akira
A
Ohta
Hajime
H
Ikeda
Takayuki
T
D000328:Adult; D016207:Cytokines / Q000097:blood; D004452:Echocardiography; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D008297:Male; D011018:Pneumonia, Pneumococcal / Q000150:complications; D018805:Sepsis / Q000150:complications*; D012772:Shock, Septic / Q000150:complications; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology
D016207:Cytokines; D018836:Inflammation Mediators