Plasma Histone H4 and Its Implications in the Setting of Sepsis-related Myocardial Dysfunction

• Published in: Balkan medical journal Vol. 37; no. 3; pp. 119 - 120
• Main Authors: Yalta, Kenan, Gürdoğan, Muhammet
• Format: Journal Article
• Language: English
• Published: Turkey Galenos Yayinevi Tic. Ltd 01-05-2020; Trakya Üniversitesi; Galenos Publishing; Galenos Publishing House
• Subjects: Infection; Medical schools; Myocardial diseases; Nature; Nitric oxide; Nitrogen oxides; Setting (Literature); Terlipressin; Tıp; Türkiye; Edirne
• ISSN: 2146-3123; 2146-3131
• DOI: 10.4274/balkanmedj.galenos.2020.2019.12.144

In clinical practice, septic cardiomyopathy (S-CMP) has been regarded as a poorly understood phenomenon with a variety of underlying mechanisms-including detrimental impacts of cytokines and nitric oxide on the myocardium-and generally presents with emerging systolic and/or diastolic dysfunction on transthoracic echocardiogram (TTE) in septic patients (1-3). Within this context, the association of inflammation markers, in particular, with left ventricular systolic dysfunction might also be substantiated by previous reports in diverse clinical scenarios other than sepsis (4). Interestingly, S-CMP, though renowned for its reversible nature (1), might not fully recover in certain settings, potentially suggesting some degree of permanent myocardial injury (3). In their recently published elegant article (1), Lu et al. (1) suggested plasma histone H4 as an important predictor of S-CMP evolution, along with vasopressor use, in a mixed population of sepsis and septic shock patients. Of note, the authors particularly focused on histone H4 both as a consequence and trigger of myocardial injury/dysfunction in the setting of S-CMP. However, though we fully agree on the important findings of the study (1), we would like to make a few comments regarding further implications of plasma histone H4 in the setting of sepsis-related myocardial dysfunction.