Comprehensive Mechanism, Novel Markers and Multidisciplinary Treatment of Severe Acute Pancreatitis-Associated Cardiac Injury – A Narrative Review release_suxv3g6derb4hliy7ocxvhgumm

Abstract

YaLan Luo,1– 3,* ZhaoXia Li,2,* Peng Ge,1– 3,* HaoYa Guo,1– 3 Lei Li,4 GuiXin Zhang,2 CaiMing Xu,2 HaiLong Chen2 1Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, Liaoning, People's Republic of China; 2Department of General Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China; 3Laboratory of Integrative Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China; 4Department of Vascular Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China*These authors contributed equally to this workCorrespondence: CaiMing Xu; HaiLong ChenDepartment of General Surgery, The First Affiliated Hospital of Dalian Medical University, Zhongshan Road 222, Dalian, 116011, Liaoning, People's Republic of ChinaTel +86-411-83635963Fax +86-411-83622844Email xucaiming_science@hotmail.com; chenhailong@dmu.edu.cnAbstract: Acute pancreatitis (AP) is one of the common acute abdominal inflammatory diseases in clinic with acute onset and rapid progress. About 20% of the patients will eventually develop into severe acute pancreatitis (SAP) characterized by a large number of inflammatory cells infiltration, gland flocculus flaky necrosis and hemorrhage, finally inducing systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS). Pancreatic enzyme activation, intestinal endotoxemia (IETM), cytokine activation, microcirculation disturbance, autonomic nerve dysfunction and autophagy dysregulation all play an essential role in the occurrence and progression of SAP. Organ dysfunction is the main cause of early death in SAP. Acute kidney injury (AKI) and acute lung injury (ALI) are common, while cardiac injury (CI) is not, but the case fatality risk is high. Many basic studies have observed obvious ultrastructure change of heart in SAP, including myocardial edema, cardiac hypertrophy, myocardial interstitial collagen [...]
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