Reduced cardiac output in imported Plasmodium falciparum malaria
Abstract Background Volume substitution remains subject of controversy in the light of effusions and oedema potentially complicating this highly febrile disease. Understanding the role of myocardial and circulatory function appears to be essential for clinical management. In the present study, cardi...
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ftdoajarticles:oai:doaj.org/article:ea7735e635d94a659dbe936af8e85a71 2023-05-15T15:11:48+02:00 Reduced cardiac output in imported Plasmodium falciparum malaria Burchard Gerd D Brattig Norbert W Wichmann Dominic Schmiedel Stefan Mehrfar Parisa Herr Johanna Cramer Jakob P 2011-06-01T00:00:00Z https://doi.org/10.1186/1475-2875-10-160 https://doaj.org/article/ea7735e635d94a659dbe936af8e85a71 EN eng BMC http://www.malariajournal.com/content/10/1/160 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-10-160 1475-2875 https://doaj.org/article/ea7735e635d94a659dbe936af8e85a71 Malaria Journal, Vol 10, Iss 1, p 160 (2011) Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2011 ftdoajarticles https://doi.org/10.1186/1475-2875-10-160 2022-12-31T01:45:17Z Abstract Background Volume substitution remains subject of controversy in the light of effusions and oedema potentially complicating this highly febrile disease. Understanding the role of myocardial and circulatory function appears to be essential for clinical management. In the present study, cardiac function and cardiac proteins have been assessed and correlated with parasitological and immunologic parameters in patients with imported Plasmodium falciparum malaria. Methods In a prospective case-control study, 28 patients with uncomplicated and complicated P. falciparum malaria were included and findings were compared with 26 healthy controls. Cardiac function parameters were assessed by an innovative non-invasive method based on the re-breathing technique. In addition, cardiac enzymes and pro- and anti-inflammatory cytokines were measured and assessed with respect to clinical symptoms and conditions of malaria. Results Cardiac index (CI) as a measurement of cardiac output (CO) was 21% lower in malaria patients than in healthy controls (2.7 l/min/m 2 versus 3.4 l/min/m 2 P < 0.001). In contrast, systemic vascular resistance index (SVRI) was increased by 29% (32.6 mmHg⋅m 2 /(l/min) versus 23.2 mmHg⋅m 2 /(l/min); P < 0.001). This correlated with increased cardiac proteins in patients versus controls: pro-BNP 139.3 pg/ml versus 60.4 pg/ml (P = 0.03), myoglobin 43.6 μg/l versus 27.8 μg/l (P = < 0.001). All measured cytokines were significantly increased in patients with malaria. CI, SVRI as well as cytokine levels did not correlate with blood parasite density. Conclusions The results support previous reports suggesting impaired cardiac function contributing to clinical manifestations in P. falciparum malaria. Findings may be relevant for fluid management and should be further explored in endemic regions. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 10 1 160 |
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Directory of Open Access Journals: DOAJ Articles |
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Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
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Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Burchard Gerd D Brattig Norbert W Wichmann Dominic Schmiedel Stefan Mehrfar Parisa Herr Johanna Cramer Jakob P Reduced cardiac output in imported Plasmodium falciparum malaria |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Volume substitution remains subject of controversy in the light of effusions and oedema potentially complicating this highly febrile disease. Understanding the role of myocardial and circulatory function appears to be essential for clinical management. In the present study, cardiac function and cardiac proteins have been assessed and correlated with parasitological and immunologic parameters in patients with imported Plasmodium falciparum malaria. Methods In a prospective case-control study, 28 patients with uncomplicated and complicated P. falciparum malaria were included and findings were compared with 26 healthy controls. Cardiac function parameters were assessed by an innovative non-invasive method based on the re-breathing technique. In addition, cardiac enzymes and pro- and anti-inflammatory cytokines were measured and assessed with respect to clinical symptoms and conditions of malaria. Results Cardiac index (CI) as a measurement of cardiac output (CO) was 21% lower in malaria patients than in healthy controls (2.7 l/min/m 2 versus 3.4 l/min/m 2 P < 0.001). In contrast, systemic vascular resistance index (SVRI) was increased by 29% (32.6 mmHg⋅m 2 /(l/min) versus 23.2 mmHg⋅m 2 /(l/min); P < 0.001). This correlated with increased cardiac proteins in patients versus controls: pro-BNP 139.3 pg/ml versus 60.4 pg/ml (P = 0.03), myoglobin 43.6 μg/l versus 27.8 μg/l (P = < 0.001). All measured cytokines were significantly increased in patients with malaria. CI, SVRI as well as cytokine levels did not correlate with blood parasite density. Conclusions The results support previous reports suggesting impaired cardiac function contributing to clinical manifestations in P. falciparum malaria. Findings may be relevant for fluid management and should be further explored in endemic regions. |
format |
Article in Journal/Newspaper |
author |
Burchard Gerd D Brattig Norbert W Wichmann Dominic Schmiedel Stefan Mehrfar Parisa Herr Johanna Cramer Jakob P |
author_facet |
Burchard Gerd D Brattig Norbert W Wichmann Dominic Schmiedel Stefan Mehrfar Parisa Herr Johanna Cramer Jakob P |
author_sort |
Burchard Gerd D |
title |
Reduced cardiac output in imported Plasmodium falciparum malaria |
title_short |
Reduced cardiac output in imported Plasmodium falciparum malaria |
title_full |
Reduced cardiac output in imported Plasmodium falciparum malaria |
title_fullStr |
Reduced cardiac output in imported Plasmodium falciparum malaria |
title_full_unstemmed |
Reduced cardiac output in imported Plasmodium falciparum malaria |
title_sort |
reduced cardiac output in imported plasmodium falciparum malaria |
publisher |
BMC |
publishDate |
2011 |
url |
https://doi.org/10.1186/1475-2875-10-160 https://doaj.org/article/ea7735e635d94a659dbe936af8e85a71 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 10, Iss 1, p 160 (2011) |
op_relation |
http://www.malariajournal.com/content/10/1/160 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-10-160 1475-2875 https://doaj.org/article/ea7735e635d94a659dbe936af8e85a71 |
op_doi |
https://doi.org/10.1186/1475-2875-10-160 |
container_title |
Malaria Journal |
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10 |
container_issue |
1 |
container_start_page |
160 |
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1766342593714585600 |