Inflammatory mechanisms and intervention strategies for sepsis‐induced myocardial dysfunction

Abstract

Sepsis‐induced myocardial dysfunction (SIMD) is the leading cause of death in patients with sepsis in the intensive care units. The main manifestations of SIMD are systolic and diastolic dysfunctions of the myocardium. Despite our initial understanding of the SIMD over the past three decades, the incidence and mortality of SIMD remain high. This may be attributed to the large degree of heterogeneity among the initiating factors, disease processes, and host states involved in SIMD. Previously, organ dysfunction caused by sepsis was thought to be an impairment brought about by an excessive inflammatory response. However, many recent studies have shown that SIMD is a consequence of a combination of factors shaped by the inflammatory responses between the pathogen and the host. In this article, we review the mechanisms of the inflammatory responses and potential novel therapeutic strategies in SIMD.

Sepsis‑induced cardiac dysfunction and pathogenetic mechanisms (Review)

“…Mitochondrial dysfunction, primarily due to increased ROS and no steady-state concentrations inside mitochondria, increases various reversible and irreversible toxic modifications on biomolecules, such as protein carbonylation and lipid peroxidation ( 28 , 131 ). Meanwhile, excessive ROS and NO damage the mitochondrial respiratory chain structure and aggravate the biosynthesis of ROS ( 132 , 133 ). Metabolism in sepsis requires the adjustment of immune function via metabolism of fat, the metabolism of amino acids, metabolism of glucose and the absorption of a large amount of energy from cell's own metabolism ( 134 , 135 ).…”

Apelin ameliorates sepsis-induced myocardial dysfunction via inhibition of NLRP3-mediated pyroptosis of cardiomyocytes

“…Sepsis, a complex life-threatening condition caused by infection, is the leading cause of morbidity and mortality encountered in emergency medicine [ 1 , 2 ]. It can lead to multiple organ damage with the heart the most important and frequently affected [ 3 , 4 ]. The incidence of sepsis-induced myocardial dysfunction (SMD) is reported to vary from 10 to 70 % in subjects with sepsis with mortality as high as 70–90 % [ 5 , 6 ].…”