{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,4,6]],"date-time":"2022-04-06T02:25:24Z","timestamp":1649211924386},"reference-count":68,"publisher":"Walter de Gruyter GmbH","issue":"2","license":[{"start":{"date-parts":[[2017,4,13]],"date-time":"2017-04-13T00:00:00Z","timestamp":1492041600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,4,13]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"j_iss-2016-0202_s_999_w2aab3b7b3b1b6b1aab1c16b1Aa\"><jats:title>Background:<\/jats:title><jats:p>This study analyzes the myocardial force-generating capacity in infective endocarditis (IE) using an experimental model of isolated human atrial myocardium. <jats:italic>In vivo<\/jats:italic>, it is difficult to decide whether or not alterations in myocardial contractile behavior are due to secondary effects associated with infection such as an altered heart rate, alterations of preload and afterload resulting from valvular defects, and altered humoral processes. Our <jats:italic>in vitro<\/jats:italic> model using isolated human myocardium, in contrast, guarantees exactly defined experimental conditions with respect to preload, afterload, and contraction frequency, thus not only preventing confounding by <jats:italic>in vivo<\/jats:italic> determinants of contractility but also excluding effects of other factors associated with sepsis, hemodynamics, humoral influences, temperature, and medical treatment.<\/jats:p><\/jats:sec><jats:sec id=\"j_iss-2016-0202_s_998_w2aab3b7b3b1b6b1aab1c16b2Aa\"><jats:title>Methods:<\/jats:title><jats:p>We analyzed right atrial trabeculae (diameter 0.3\u20130.5 mm, initial length 5 mm) from 32 patients undergoing aortic and\/or mitral valve replacement for acute valve incompetence caused by IE and 65 controls receiving aortic and\/or mitral valve replacement for nonendocarditic valve incompetence. Isometric force amplitudes and passive resting force values measured at optimal length in the two groups were compared using Student\u2019s t-test.<\/jats:p><\/jats:sec><jats:sec id=\"j_iss-2016-0202_s_997_w2aab3b7b3b1b6b1aab1c16b3Aa\"><jats:title>Results:<\/jats:title><jats:p>There were no significant differences between the groups in terms of the passive resting force. The isometric force amplitude in the endocarditis group, however, was significantly lower than in the nonendocarditis group (p=0.001). In the endocarditis group, the calculated active force, defined as the isometric force amplitude minus the resting force, was significantly lower (p&lt;0.0001) and the resting force\/active force ratio was significantly higher (p&lt;0.0001). Using linear regression to describe the function between resting force and active force, we identified a significant difference in slope (p&lt;0.0001), with lower values found in the endocarditis group.<\/jats:p><\/jats:sec><jats:sec id=\"j_iss-2016-0202_s_996_w2aab3b7b3b1b6b1aab1c16b4Aa\"><jats:title>Conclusion:<\/jats:title><jats:p>Our data suggest that the force-generating capacity of atrial myocardium is significantly reduced in patients with IE. In these patients, an elevated resting force is required to achieve a given force amplitude. It remains unclear, however, whether this is due to calcium desensitization of the contractile apparatus, presence of myocardial edema, fibrotic remodeling, disruption of contractile units, or other mechanisms.<\/jats:p><\/jats:sec>","DOI":"10.1515\/iss-2016-0202","type":"journal-article","created":{"date-parts":[[2017,4,13]],"date-time":"2017-04-13T10:00:53Z","timestamp":1492077653000},"page":"81-87","source":"Crossref","is-referenced-by-count":1,"title":["Septic cardiomyopathy: evidence for a reduced force-generating capacity of human atrial myocardium in acute infective endocarditis"],"prefix":"10.1515","volume":"2","author":[{"given":"Katja","family":"Buschmann","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Hospital of the Johannes Gutenberg-University Mainz, Langenbeckstra\u00dfe 1, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"Chaban","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Hospital of the Johannes Gutenberg-University Mainz, Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna Lena","family":"Emrich","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Hospital of the Johannes Gutenberg-University Mainz, Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marwan","family":"Youssef","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Hospital of the Johannes Gutenberg-University Mainz, Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Kornberger","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Hospital of the Johannes Gutenberg-University Mainz, Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andres","family":"Beiras-Fernandez","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Hospital of the Johannes Gutenberg-University Mainz, Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian Friedrich","family":"Vahl","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Hospital of the Johannes Gutenberg-University Mainz, Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","reference":[{"key":"ref141","doi-asserted-by":"crossref","first-page":"2094","DOI":"10.1097\/CCM.0000000000001162","article-title":"Circulating histones are major mediators of cardiac injury in patients with sepsis","volume":"43","year":"2015","journal-title":"Crit Care Med"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.ahj.2012.04.003","article-title":"Excess mortality and morbidity in patients surviving IE","volume":"164","year":"2012","journal-title":"Am Heart J"},{"key":"ref31","journal-title":"Septic shock. 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