Incidence,prognosis,and risk factors of sepsis-induced cardiomyopathy

BACKGROUND At present,large-scale studies on the clinical characteristics of sepsis-induced cardiomyopathy(SIC)are lacking.AIM To investigate the clinical characteristics of SIC.METHODS Based on the analysis of the MIMIC-III public database,we performed a largescale retrospective study involving sepsis patients who were admitted to the intensive care unit(ICU)and had no concomitant cardiac disease.We used propensity score matching analysis and multivariate logistic regression to ensure the robustness of the results.The primary outcome was hospital mortality,and the secondary outcomes included the number of patients who received mechanical ventilation or renal replacement therapy during their hospital stay,the number of patients administered with vasopressors,the length of ICU stay,and the length of hospital stay.RESULTS In the present study,after screening 38605 patients,3530 patients with sepsis were included.A total of 997 patients met the SIC diagnostic criteria,and the incidence of SIC was 28.20%(95%confidence interval[CI]:26.80%-29.70%).Compared to patients in the non-SIC group,patients in the SIC group were of older age and had a higher Simplified Acute Physiology Score(SAPS)-Ⅰ score,SAPS-Ⅱ score,and Elixhauser comorbidity index(ECI).A total of 367(36.8%)of 997 patients in the SIC group and 818(32.3%)of 2533 patients in the non-SIC group died in the hospital,which resulted in a significant between-group difference(odds ratios=1.22,95%CI:1.05-1.42;P=0.011).For the secondary outcomes,more patients in the SIC group received mechanical ventilation and vasopressors.Multivariate logistic regression analysis showed that age,male sex,ECI,hemoglobin level,diabetes,and mechanical ventilation use on the first day of ICU admission were risk factors for SIC.CONCLUSION Compared with non-SIC patients,hospital mortality is higher in SIC patients.

Low Shear Stress Regulating Autophagy Mediated by the p38 Mitogen Activated Protein Kinase and p53 Pathways in Human Umbilical Vein Endothelial Cells

To the Editor：Autophagy is reported to play a critical role in low shear stress （LSS）-induced endothelial cell injury and the formation of atherosclerotic plaques.[1] However,the corresponding mechanisms remain unclear.[2-8] This study was to investigate the changes and mechanism of LSS-induced autophagy in human umbilical vein endothelial cells （HUVECs）.HUVECs were treated with LSS of 5 dyn/cm2 for 0,5,15,30,and 60 min in a parallel plate flow chamber system.Light chain （LC） Ⅱ,LC3 Ⅰ,and p62,p38 mitogen-activated protein kinase （MAPK） and their protein of phosphorylation of p38 （p-p38） were detected with Western blot analysis.The protein levels of p-p53 （ser15） and their distribution were detected by immunofluorescence （IF）.