Septic cardiomyopathy

    Authors

    Keywords

    sepsis-induced myocardial dysfunction, septic cardiomyopathy, echocardiography

    DOI

    https://doi.org/10.15836/ccar2024.515

    Full Text

    The development of myocardial dysfunction in sepsis is associated with an increased mortality rate, and the prevalence of the development of septic cardiomyopathy in patients with sepsis ranges from 10-70%, depending on the research. Previous research has established that it is a global and reversible dysfunction of the myocardium. Almost half of these patients develop diastolic and systolic myocardial dysfunction. The presence of diastolic dysfunction is an early biomarker of the development of septic cardiomyopathy and has prognostic significance. Current research shows that myocardial damage occurs because of weakened myocardial perfusion, the direct adverse effect of inflammatory mediators, and bacteria and their toxins, as well as mitochondrial dysfunction. It is the consequences of the development of mitochondrial dysfunction that represent a key problem in the development of sepsis-induced cardiomyopathy. The pathophysiological mechanisms of the development of sepsis-induced myocardial dysfunction are the subject of many studies, and certainly the results of these studies have an impact on the therapeutic approach itself. The use of advanced echocardiographic methods, such as global longitudinal strain and magnetic resonance imaging, is a sufficiently sensitive method in the detection of sepsis-induced cardiomyopathy, but there are limitations to its application in the Intensive Care Unit. Current therapeutic possibilities in treatment of sepsis-induced cardiomyopathy include achieving hemodynamic stability of the patient and the use of antibiotic therapy. The discovery of new treatment methods is based on animal models, and the goal of immunomodulatory action at the cellular level, to reduce myocardial injury. (1-3) The aim of this paper is to present the current knowledge about the development of myocardial dysfunction associated with sepsis, and to review biomarkers, diagnostic methods in its recognition, as well as possible therapeutic methods in development.

    Literature

    1. Hiraiwa H, Kasugai D, Okumura T, Murohara T. Clinical implications of septic cardiomyopathy: A narrative review. Medicine (Baltimore). 2024 April 26;103(17):e37940. https://doi.org/10.1097/MD.0000000000037940
    2. Lukić I, Mihić D, Varžić SC, Relatić KS, Zibar L, Loinjak D, et al. Septic Cardiomyopathy. Rev Cardiovasc Med. 2024 January 15;25(1):23. https://doi.org/10.31083/j.rcm2501023
    3. Lima MR, Silva D. Septic cardiomyopathy: A narrative review. Rev Port Cardiol. 2023 May;42(5):471–81. https://doi.org/10.1016/j.repc.2021.05.020
    Cardiologia Croatica
    Back to search

    Septic cardiomyopathy

    Extended Abstract
    Issue11-12
    Published
    Pages515
    PDF via DOIhttps://doi.org/10.15836/ccar2024.515
    sepsis-induced myocardial dysfunction
    septic cardiomyopathy
    echocardiography

    Authors

    Lana Maričić*ORCIDUniversity Hospital Centre Osijek, Osijek, Croatia

    *Correspondence email: dr.lmaricic@gmail.com

    Full Text

    The development of myocardial dysfunction in sepsis is associated with an increased mortality rate, and the prevalence of the development of septic cardiomyopathy in patients with sepsis ranges from 10-70%, depending on the research. Previous research has established that it is a global and reversible dysfunction of the myocardium. Almost half of these patients develop diastolic and systolic myocardial dysfunction. The presence of diastolic dysfunction is an early biomarker of the development of septic cardiomyopathy and has prognostic significance. Current research shows that myocardial damage occurs because of weakened myocardial perfusion, the direct adverse effect of inflammatory mediators, and bacteria and their toxins, as well as mitochondrial dysfunction. It is the consequences of the development of mitochondrial dysfunction that represent a key problem in the development of sepsis-induced cardiomyopathy. The pathophysiological mechanisms of the development of sepsis-induced myocardial dysfunction are the subject of many studies, and certainly the results of these studies have an impact on the therapeutic approach itself. The use of advanced echocardiographic methods, such as global longitudinal strain and magnetic resonance imaging, is a sufficiently sensitive method in the detection of sepsis-induced cardiomyopathy, but there are limitations to its application in the Intensive Care Unit. Current therapeutic possibilities in treatment of sepsis-induced cardiomyopathy include achieving hemodynamic stability of the patient and the use of antibiotic therapy. The discovery of new treatment methods is based on animal models, and the goal of immunomodulatory action at the cellular level, to reduce myocardial injury. (1–3) The aim of this paper is to present the current knowledge about the development of myocardial dysfunction associated with sepsis, and to review biomarkers, diagnostic methods in its recognition, as well as possible therapeutic methods in development.

    Literature

    1. 1.
      Hiraiwa H, Kasugai D, Okumura T, Murohara T. Clinical implications of septic cardiomyopathy: A narrative review. Medicine (Baltimore). 2024 April 26;103(17):e37940.DOI
    2. 2.
      Lukić I, Mihić D, Varžić SC, Relatić KS, Zibar L, Loinjak D, et al. Septic Cardiomyopathy. Rev Cardiovasc Med. 2024 January 15;25(1):23.DOI
    3. 3.
      Lima MR, Silva D. Septic cardiomyopathy: A narrative review. Rev Port Cardiol. 2023 May;42(5):471–81.DOI