Hackensack Meridian School of Medicine, Hackensack University Medical Center, Hackensack, NJ, USA.
Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London, London, UK.
Nat Rev Cardiol. 2021 Jun;18(6):424-434. doi: 10.1038/s41569-020-00492-2. Epub 2021 Jan 20.
Sepsis is the life-threatening organ dysfunction caused by a dysregulated host response to infection and is the leading cause of death in intensive care units. Cardiac dysfunction caused by sepsis, usually termed sepsis-induced cardiomyopathy, is common and has long been a subject of interest. In this Review, we explore the definition, epidemiology, diagnosis and pathophysiology of septic cardiomyopathy, with an emphasis on how best to interpret this condition in the clinical context. Advances in diagnostic techniques have increased the sensitivity of detection of myocardial abnormalities but have posed challenges in linking those abnormalities to therapeutic strategies and relevant clinical outcomes. Sophisticated methodologies have elucidated various pathophysiological mechanisms but the extent to which these are adaptive responses is yet to be definitively answered. Although the indications for monitoring and treating septic cardiomyopathy are clinical and directed towards restoring tissue perfusion, a better understanding of the course and implications of septic cardiomyopathy can help to optimize interventions and improve clinical outcomes.
脓毒症是一种宿主对感染的失调反应导致的危及生命的器官功能障碍，是重症监护病房死亡的主要原因。脓毒症引起的心脏功能障碍，通常称为脓毒性心肌病，较为常见，一直以来都是研究的热点。在这篇综述中，我们探讨了脓毒性心肌病的定义、流行病学、诊断和病理生理学，重点介绍了如何在临床背景下最好地解释这种情况。诊断技术的进步提高了心肌异常检测的敏感性，但在将这些异常与治疗策略和相关临床结果联系起来方面带来了挑战。复杂的方法学阐明了各种病理生理学机制，但这些机制在多大程度上是适应性反应尚有待明确回答。尽管监测和治疗脓毒性心肌病的指征是临床的，并针对恢复组织灌注，但更好地了解脓毒性心肌病的病程和影响有助于优化干预措施并改善临床结果。
