NOS2 and Other metabolic disease: The mechanisms underlying cardiac dysfunction in sepsis are not completely understood but include the following main mechanisms: (a) increased release of pro-inflammatory cytokines [3], (b) apoptotic myocardial cell death via activation of extrinsic and intrinsic pathways, (c) metabolic disorders and inducible nitric oxide synthase (NOS)-dependent action [4], (d) cardiac-depressant action of lysozyme c primarily originating from disintegrating neutrophils and monocytes [5], and (e) mitochondrial dysfunction [6, 7].