[Myocardial dysfunction in sepsis--definition and pathogenetic mechanisms].

Area of Science:

• Cardiology
• Intensive Care Medicine
• Pathophysiology

Context:

• Sepsis is a leading cause of death in intensive care units (ICUs).
• Septic myocardial dysfunction (SMD) affects a significant proportion of severe sepsis patients.
• Cardiac dysfunction in sepsis ranges from mild diastolic issues to severe biventricular failure.

Purpose:

• To summarize the characteristics and potential mechanisms of septic myocardial dysfunction (SMD).
• To highlight the incidence and clinical presentation of cardiac dysfunction in sepsis.
• To discuss the reversibility and potential compensatory role of SMD.

Summary:

• Septic myocardial dysfunction (SMD) is common in severe sepsis, presenting as reduced ejection fraction (EF) and ventricular dilation.
• Typical features include reversible cardiac dysfunction within 7-10 days in survivors.
• Key mechanisms involve endothelial, microcirculatory, and mitochondrial dysfunction, alongside circulating factors.

Impact:

• Understanding SMD is crucial for managing critically ill patients with sepsis.
• Recognizing the temporary and reversible nature of SMD can guide treatment strategies.
• Further research into SMD mechanisms may reveal therapeutic targets to improve sepsis outcomes.