Right heart ischemia in cases of sepsis

Article Article scientifique Article Right heart ischemia in cases of sepsis eng 2016 author Fracasso Tony 731584 author Jentgens L author Pfeiffer Helmut 62938 author Sauerland C author Mangin Patrice 662095 author Schmeling A 106-109 10.1016/j.forsciint.2015.12.002 26773220 0379-0738 Data from the literature suggest that cases of sepsis complicated by right ventricular (RV) dysfunction have poorer prognosis. In these cases progressive hypoperfusion associated to increasing, injury-related, pulmonary vascular resistance account for RV ischemia. In the present analysis, we wanted to evaluate whether prevalent RV cardiac ischemic damage could be detected in a series of fatal sepsis cases. We retrospectively investigated 20 cases of sepsis that underwent forensic autopsy (study group-11♀, 9♂, mean age 57 years) and compared them to a group of 20 cases of hanging (hanging group-4 ♀, 16 ♂, mean age 44 years) as well as to a group of 20 cases of myocardial infarction (MI group-9 ♀, 11 ♂, mean age 65 years), as examples of cardiac damage due to global hypoxia during agony and ischemic damage, respectively. We performed immunohistochemistry with the antibodies anti-fibronectin and C5b-9. The reactions were semiquantitively classified and the groups were compared. In 30% of the cases of sepsis prevalent RV ischemic damage could be detected with the antibody anti-fibronectin. This expression was significantly different from that observed in cases of MI (p=0.028) and hanging (p<0.001). Our study showed that, in cases of fatal sepsis, prevalent RV ischemic damage occurred in a substantial minority of cases. Adult Aged Female Heart Ventricles/pathology Humans Male Middle Aged Myocardial Ischemia/complications Retrospective Studies Sepsis/complications Dewey 614.1 67 Institut de médecine légale 22A2 false 953 Groupe Fracasso Tony 959 Forensic Science International 259 833fc3ac-8269-4e4b-9e1c-2decda4e5de8 Article (Published version) Restricted 26773220.pdf 1169723 application/pdf restrictedAccess Faculté de médecine / Section de médecine clinique / Département de santé et médecine communautaires / Institut de médecine légale

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Right heart ischemia in cases of sepsis	Forensic Science International			2016	431	0

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Pfeiffer, Helmut