Document Detail

Sodium/hydrogen exchange activity in sepsis and in sepsis complicated by previous injury: 31P and 23Na NMR study.
MedLine Citation:
PMID:  15753754     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Sepsis or septic shock occurs frequently in sick and injured patients and is associated with a significant mortality. Myocardial contractile dysfunction has been proposed to be a major determinant of sepsis-related mortality. This study was directed to examine the role of Na/H exchange activity in myocardial defects after sepsis or after sepsis complicated by a previous burn injury. DESIGN: Laboratory study. SETTING: University research laboratory. SUBJECTS: Sprague-Dawley rats (300-350 g, males). INTERVENTIONS: Cardiac function, cellular Na and Ca, myocardial pH, and high-energy phosphates were examined in perfused hearts harvested after sepsis alone (intratracheal Streptococcus pneumoniae, 0.4 mL of 1 x 10 CFU/mL), after sepsis complicated by previous burn injury (40% total body surface area), and after amiloride (a selective inhibitor of Na/H exchange) treatment of either sepsis alone or sepsis plus burn. MEASUREMENTS AND RESULTS: The ratio of Na signal from the intracellular compartment (Nai) compared with an external standard (monitored by Na-NMR spectroscopy, TmDOTP shift reagent) increased by 70% in sepsis alone and by 41% in sepsis complicated by previous burn injury compared with shams. Cardiac adenosine triphosphate and intracellular pH (P nuclear magnetic resonance spectroscopy) were unchanged by sepsis or sepsis plus burn. Left ventricular pressure and maximal change in pressure over time were reduced after sepsis or after sepsis plus burn injury. Amiloride treatment in either sepsis or sepsis complicated by a previous burn injury prevented myocardial Na and Ca accumulation, attenuated sepsis-related lactic acidosis, and improved left ventricular function. CONCLUSION: Our results suggest that sepsis-related cardiac dysfunction is mediated, in part, by Na/H exchange activity, and inhibition of Na/H exchange activity improves cardiac function after sepsis alone or sepsis complicated by a previous injury.
Patricia J Sikes; Piyu Zhao; David L Maass; Jean White; Jureta W Horton
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Critical care medicine     Volume:  33     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-03-08     Completed Date:  2005-04-08     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  605-15     Citation Subset:  AIM; IM    
UT Southwestern Medical Center Department of Surgery, Dallas, Texas, USA.
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MeSH Terms
Amiloride / pharmacology
Burns / complications*
Cardiomyopathies / etiology,  metabolism*
Hydrogen-Ion Concentration
Ion Exchange
Magnetic Resonance Spectroscopy
Myocardial Contraction / drug effects
Myocytes, Cardiac / drug effects,  metabolism*
Pneumonia, Aspiration / complications,  physiopathology
Rats, Sprague-Dawley
Sepsis / complications,  metabolism*
Sodium / metabolism*
Grant Support
1R01 GM57054-05/GM/NIGMS NIH HHS
Reg. No./Substance:
2609-46-3/Amiloride; 7440-23-5/Sodium
Comment In:
Crit Care Med. 2005 Mar;33(3):690-1   [PMID:  15753776 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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