Types of Septic Cardiomyopathy: Prognosis and Influencing Factors - A Clinical Study.

Objective: To explore the prognostic outcomes associated with different types of septic cardiomyopathy and analyze the factors that exert an influence on these outcomes. Methods: The data collected within 24 hours of ICU admission included cardiac troponin I (cTnI), N-terminal pro-Brain Natriuretic Peptide (NT-proBNP); SOFA (sequential organ failure assessment) scores, and the proportion of vasopressor use. Based on echocardiographic outcomes, septic cardiomyopathy was categorized into left ventricular (LV) systolic dysfunction, LV diastolic dysfunction, and right ventricular (RV) systolic dysfunction. Differences between the mortality and survival groups, as well as between each cardiomyopathy subgroup and the non-cardiomyopathy group were compared, to explore the influencing factors of cardiomyopathy. Results: A cohort of 184 patients were included in this study, with LV diastolic dysfunction having the highest incidence rate (43.5%). The mortality group had significantly higher SOFA scores, vasopressor use, and cTnI levels compared to the survival group; the survival group had better LV diastolic function than the mortality group (p < 0.05 for all). In contrast to the non-cardiomyopathy group, each subgroup within the cardiomyopathy category exhibited elevated levels of cTnI. The subgroup with left ventricular diastolic dysfunction demonstrated a higher prevalence of advanced age, hypertension, diabetes mellitus, coronary artery disease, and an increased mortality rate; the RV systolic dysfunction subgroup had higher SOFA scores and NT-proBNP levels, and a higher mortality rate (P < 0.05 for all); the LV systolic dysfunction subgroup had a similar mortality rate (P > 0.05). Conclusion: Patients with advanced age, hypertension, diabetes mellitus, or coronary artery disease are more prone to develop LV diastolic dysfunction type of cardiomyopathy; cardiomyopathy subgroups had higher levels of cTnI. The RV systolic dysfunction cardiomyopathy subgroup had higher SOFA scores and NT-proBNP levels. The occurrence of RV systolic dysfunction in patients with sepsis significantly increased the mortality rate.

Metal release from contaminated coastal sediments under changing pH conditions: Implications for metal mobilization in acidified oceans.

To investigate the impacts and processes of CO2-induced acidification on metal mobilization, laboratory-scale experiments were performed, simulating the scenarios where carbon dioxide was injected into sediment-seawater layers inside non-pressurized chambers. Coastal sediments were sampled from two sites with different contamination levels and subjected to pre-determined pH conditions. Sediment samples and overlying water were collected for metal analysis after 10-days. The results indicated that CO2-induced ocean acidification would provoke increased metal mobilization causing adverse side-effects on water quality. The mobility of metals from sediment to the overlying seawater was correlated with the reduction in pH. Results of sequential extractions of sediments illustrated that exchangeable metal forms were the dominant source of mobile metals. Collectively, our data revealed that high metal concentrations in overlying seawater released from contaminated sediments under acidic conditions may strengthen the existing contamination gradients in Maluan Bay and represent a potential risk to ecosystem health in coastal environments.

Combined use of DGT and transplanted shrimp (Litopenaeus vannamei) to assess the bioavailable metals of complex contamination: implications for implementing bioavailability-based water quality criteria.

The diffusive gradients in thin films (DGT) were field deployed alongside the shrimp Litopenaeus vannamei at seven sites with different levels of contamination to assess the potentially bioavailable and toxic fraction of metal contaminants. After 7 days of exposure, several antioxidant biomarkers were quantified in hepatopancreas of exposed shrimps, and tissue levels as well as the total, dissolved, and DGT-labile concentrations of metal contaminants were determined in the pooled site samples. The results showed that the caged shrimps had high tissue contaminant concentrations and significantly inhibited antioxidant responses at the more contaminated sites. DGT-labile metal concentrations provided better spatial resolution of differences in metal contamination when compared with traditional bottle sampling and transplanted shrimp. The total, dissolved, and DGT-labile metal fractions were used to evaluate the potential bioavailability of metal contaminants, comparing with metal accumulation and further linking to antioxidant biomarker responses in tissues of exposed shrimps. Regression analysis showed the significant correlations between DGT-Cu concentrations and tissue-Cu and activities of some biomarker responses in the shrimp hepatopancreas. This indicated that DGT-labile Cu concentrations provided the better prediction of produced biological effects and of the bioavailability than the total or dissolved concentrations. The study supports the use of methods combining transplanted organisms and passive sampling for assessing the chemical and ecotoxicological status of aqueous environments and demonstrates the capability of the DGT technique as a powerful tool for measuring the bioavailability-based water quality in variable coastal environments.