Department of Critical Care Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China.
Mol Med Rep. 2022 Aug;26(2). doi: 10.3892/mmr.2022.12773. Epub 2022 Jun 15.
Sepsis‑induced cardiac dysfunction is one of the most common types of organ dysfunction in sepsis; its pathogenesis is highly complex and not yet fully understood. Cardiomyocytes serve a key role in the pathophysiology of cardiac function; due to the limited ability of cardiomyocytes to regenerate, their loss contributes to decreased cardiac function. The activation of inflammatory signalling pathways affects cardiomyocyte function and modes of cardiomyocyte death in sepsis. Prevention of cardiomyocyte death is an important therapeutic strategy for sepsis‑induced cardiac dysfunction. Thus, understanding the signalling pathways that activate cardiomyocyte death and cross‑regulation between death modes are key to finding therapeutic targets. The present review focused on advances in understanding of sepsis‑induced cardiomyocyte death pathways, including apoptosis, necroptosis, mitochondria‑mediated necrosis, pyroptosis, ferroptosis and autophagy. The present review summarizes the effect of inflammatory activation on cardiomyocyte death mechanisms, the diversity of regulatory mechanisms and cross‑regulation between death modes and the effect on cardiac function in sepsis to provide a theoretical basis for treatment of sepsis‑induced cardiac dysfunction.
脓毒症相关性心功能障碍是脓毒症中最常见的器官功能障碍类型之一；其发病机制非常复杂，尚未完全阐明。心肌细胞在心脏功能的病理生理学中起着关键作用；由于心肌细胞的再生能力有限，其丧失导致心功能下降。炎症信号通路的激活影响脓毒症中心肌细胞的功能和死亡方式。预防心肌细胞死亡是脓毒症相关性心功能障碍的重要治疗策略。因此，了解激活心肌细胞死亡的信号通路以及死亡方式之间的交叉调控是寻找治疗靶点的关键。本综述重点介绍了对脓毒症诱导的心肌细胞死亡途径的理解进展，包括细胞凋亡、坏死性凋亡、线粒体介导的坏死、细胞焦亡、铁死亡和自噬。本综述总结了炎症激活对心肌细胞死亡机制、调控机制多样性以及死亡方式之间交叉调控的影响以及对脓毒症中心脏功能的影响，为脓毒症相关性心功能障碍的治疗提供理论依据。
