Oxidative-Nitrosative Stress and Myocardial Dysfunctions in Sepsis: Evidence from the Literature and Postmortem Observations

Figure 2

Inducible nitric oxide synthase (iNOS) expression in the cardiac tissue of patient died following sepsis. Bright field (a) and contrast phase (b) microscopy image of cardiac sample, showing a moderate immunopositivity to anti-iNOS antibody (Santa Cruz, CA, USA). Personal observation of a 38-year-old woman with no history of cardiac disease who was referred to an intensive care unit from the obstetrics department 3 days after a cesarean delivery. She was febrile, and laboratory findings included a white blood cell count of 12,800/mm³. A postpartum sepsis was diagnosed. Echocardiography showed severe LV systolic function and hypokinesia. Coronary angiography on the same day revealed no significant coronary stenoses. Because of the patient’s hemodynamic instability, medical treatment that included inotropic agents and antibiotics was started. She did not respond to the treatment and three days later died.

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