| Cardiogenic shock: the role of inflammation. | |
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MedLine Citation:
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PMID: 21039083 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Cardiogenic shock (CS) is the leading cause of death in patients with acute myocardial infarction (MI) and we badly need new approaches in its treatment. It has been demonstrated that a number of inflammatory cytokines (IL-1β, IL-6, IL-8, TNF-α, CRP, soluble adhesion molecules, complement system etc) are elevated in acute MI complicated by CS. Baseline levels of pro- inflammatory cytokines have predictive value for the development of CS and subsequent mortality. The deleterious effects of pro- inflammatory cytokines may be due to excessive nitric oxide production by enzyme named NOS. However in multicenter randomized TRIUMPH study non-selective NOS inhibition was ineffective in the treatment of cardiogenic shock. A challenging subject of future studies will be treatment of CS with specific inhibitors of inducible isoform of NOS. Considering the results of treatment of patients with septic shock it would be reasonable to study the effects of small doses of corticosteroids and hemofiltration in patients with CS and signs of SIRS. |
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Authors:
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Alexander Shpektor |
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10446833 - Microcirculatory oxygenation and shunting in sepsis and shock. 18086373 - Role of toll-like receptor responses for sepsis pathogenesis. 616743 - Interaction of intracellular proteases and immune mechanisms. |
Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Acute cardiac care Volume: 12 ISSN: 1748-295X ISO Abbreviation: Acute Card Care Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-02 Completed Date: 2010-12-20 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101276603 Medline TA: Acute Card Care Country: England |
Other Details:
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Languages: eng Pagination: 115-8 Citation Subset: IM |
Affiliation:
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Cardiology Department, Moscow State University of Medicine and Dentistry, Moscow, Russia. moscowcardio_23@yahoo.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenal Cortex Hormones
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therapeutic use Cytokines / physiology Enzyme Inhibitors / therapeutic use Hemofiltration Humans Myocardial Infarction / complications Nitric Oxide / physiology Nitric Oxide Synthase / antagonists & inhibitors, physiology Randomized Controlled Trials as Topic Shock, Cardiogenic / etiology, immunology*, metabolism, physiopathology, therapy Systemic Inflammatory Response Syndrome / immunology, metabolism, physiopathology*, therapy Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Adrenal Cortex Hormones; 0/Cytokines; 0/Enzyme Inhibitors; 10102-43-9/Nitric Oxide; EC 1.14.13.39/Nitric Oxide Synthase |
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