Pathophysiology of Sepsis-Related Cardiac Dysfunction: Driven by Inflammation, Energy Mismanagement, or Both?

被引：159
作者：
Drosatos K. [1 ]
Lymperopoulos A. [2 ]
Kennel P.J. [3 ]
Pollak N. [4 ]
Schulze P.C. [3 ]
Goldberg I.J. [5 ]
机构：
[1] Metabolic Biology Laboratory, Center for Translational Medicine, Department of Pharmacology, Temple University School of Medicine, 3500 N. Broad Street, MERB-951, Philadelphia, 19140, PA
[2] Neurohormonal Control of the Circulation Lab, Department of Pharmaceutical Sciences, Nova Southeastern University College of Pharmacy, 3200 S. University Dr., Health Professions Division (Terry) Bldg/Room 1338, Fort Lauderdale, 33328, FL
[3] Division of Cardiology, Columbia University College of Physicians and Surgeons, New York, 10032, NY
[4] Institute of Molecular Biosciences, University of Graz, Graz
[5] Division of Endocrinology, Diabetes & Metabolism, NYU-Langone School of Medicine, 522 First Avenue, New York, 10016, NY
来源：
Current Heart Failure Reports | 2015年 / 12卷 / 2期
关键词：
Adrenergic signaling; Fatty acid oxidation; Heart; Inflammation; Metabolism; Sepsis;
D O I：
10.1007/s11897-014-0247-z
中图分类号：
学科分类号：
摘要：
Sepsis is a systemic inflammatory response that follows bacterial infection. Cardiac dysfunction is an important consequence of sepsis that affects mortality and has been attributed to either elevated inflammation or suppression of both fatty acid and glucose oxidation and eventual ATP depletion. Moreover, cardiac adrenergic signaling is compromised in septic patients and this aggravates further heart function. While anti-inflammatory therapies are important for the treatment of the disease, administration of anti-inflammatory drugs did not improve survival in septic patients. This review article summarizes findings on inflammatory and other mechanisms that are triggered in sepsis and affect cardiac function and mortality. Particularly, it focuses on the effects of the disease in metabolic pathways, as well as in adrenergic signaling and the potential interplay of the latter with inflammation. It is suggested that therapeutic approaches should include combination of anti-inflammatory treatments, stimulation of energy production, and restoration of adrenergic signaling in the heart. © 2014, Springer Science+Business Media New York.
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页码：130 / 140
页数：10
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