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Published on: May 2, 2017
Cardiac dysfunction in critical illness
1University of Chicago, 5841 S. Maryland Ave, MC 4028, Chicago, IL 60637, USA.
Insights
Sepsis-induced cardiomyopathy involves complex interactions leading to heart dysfunction. New biomarkers and advanced echocardiography aid in predicting and diagnosing this condition, paving the way for future therapeutic strategies.
Area of Science:
- Cardiology
- Intensive Care Medicine
- Pathophysiology
Background:
- Sepsis and septic shock are increasing health concerns with high mortality rates.
- Sepsis-induced cardiac dysfunction contributes significantly to patient morbidity and mortality.
- Understanding the complex pathophysiology is crucial for developing effective treatments.
Purpose of the Study:
- To review current knowledge on sepsis-induced cardiomyopathy.
- To highlight advances in understanding the physiological interactions involved.
- To explore potential therapeutic targets for sepsis-induced cardiac dysfunction.
Main Methods:
- Review of recent scientific literature on sepsis-induced cardiomyopathy.
- Analysis of diagnostic advancements, including echocardiography.
- Examination of identified biomarkers and their predictive value.
Main Results:
- Multiple biomarkers predict morbidity and mortality in sepsis-induced cardiomyopathy.
- Enhanced echocardiography detects subclinical cardiac dysfunction.
- This dysfunction has implications for disease progression and management.
Conclusions:
- Sepsis-induced cardiomyopathy arises from intricate pathogen, host response, and iatrogenic factors.
- Inflammatory, metabolic, and adrenergic systems contribute to myocardial injury, impairing cardiac function.
- Further research into mediators will likely reveal novel therapeutic targets.
Purpose Of Review:
Sepsis and septic shock are prevalent conditions that are likely to increase in prevalence in the future. Given the high mortality and morbidity associated with sepsis and sepsis-induced cardiac dysfunction, we must continue to make advances in knowledge of the complex physiologic interactions and how we may target specific mediators for potential therapeutic options in the future.
Recent Findings:
Multiple biomarkers have been discovered, which when assayed in sepsis-induced cardiomyopathy predict morbidity and mortality. With increased sensitivity of echocardiography, we can diagnose subclinical cardiac dysfunction, which may have future implications for slowing or preventing progressive dysfunction.
Summary:
Sepsis-induced cardiomyopathy is the result of complicated interactions between the pathogen, the body's response to infection, and iatrogenic injury. Interplay between inflammatory, metabolic, and adrenergic systems results in direct and indirect myocardial injury leading to decreases in both systolic and diastolic cardiac function. As the interactions are further elucidated with additional research into other proteins and mediators, new treatment options can be researched. VIDEO ABSTRACT.
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