Division of Pulmonary Disease & Critical Care Medicine, Virginia Commonwealth University, P.O. Box 980050, Richmond, VA, 23298-0050, USA.
Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA.
Curr Cardiol Rep. 2020 May 6;22(5):35. doi: 10.1007/s11886-020-01277-2.
To briefly review epidemiology and pathophysiology of SICM and provide a more extensive review of the data on diagnostic and management strategies.
SICM is likely underdiagnosed and that has mortality implications. Current evidence supports speckle tracking echocardiography to identify decreased contractility irrespective of left ventricular ejection fraction for the diagnosis of SICM. There continues to be a dearth of large clinical trials evaluating the treatment of SICM and current consensus focuses on supportive measures such as vasopressors and inotropes. Sepsis is a significant cause of mortality, and sepsis-induced cardiomyopathy has both prognostic and management implications for these patients. Individualized work-up and management of these patients is crucial to improving outcomes.
简要回顾心尖内科学(SICM)的流行病学和病理生理学,并对其诊断和治疗策略的数据进行更广泛的回顾。
SICM 可能诊断不足,这意味着存在死亡率问题。目前的证据支持斑点追踪超声心动图来识别收缩功能障碍,而不考虑左心室射血分数,以诊断 SICM。目前仍然缺乏评估 SICM 治疗的大型临床试验,而目前的共识侧重于支持性措施,如血管加压素和正性肌力药。脓毒症是导致死亡率的一个重要原因,脓毒症性心肌病对这些患者的预后和治疗都有影响。对这些患者进行个体化的检查和管理对于改善预后至关重要。