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脓毒症相关性心肌病:对重症监护病房医生来说并非易事。

Sepsis-related cardiomyopathy: Not an easy task for ICU physicians.

作者信息

Zhang Hongmin, Liu Dawei

机构信息

Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.

出版信息

J Intensive Med. 2022 Jun 25;2(4):257-259. doi: 10.1016/j.jointm.2022.05.005. eCollection 2022 Oct.

Abstract

Sepsis-induced myocardial dysfunction is common. In addition to acute coronary syndrome, at least two types of left ventricular dysfunction can occur in septic patients: typical septic cardiomyopathy (SC) and sepsis-related takotsubo cardiomyopathy (ST). Although the definition of septic cardiomyopathy is based on left ventricular (LV) systolic dysfunction, both ventricles can be affected. In this context, it has been increasingly recognized that right ventricular (RV) systolic dysfunction is associated with long-term prognosis in septic patients. Unlike typical SC, ST patients usually displayed LV apical and circumferential mid-ventricular hypokinesia and basal hypercontractility. Timely and precise evaluation of heart dysfunction in sepsis patients is not easy but obviously mandatory. Further studies are still warranted regarding the mechanism, evaluation, and management of septic cardiomyopathy.

摘要

脓毒症诱发的心肌功能障碍很常见。除急性冠状动脉综合征外,脓毒症患者至少可出现两种类型的左心室功能障碍:典型的脓毒症性心肌病(SC)和脓毒症相关的应激性心肌病(ST)。尽管脓毒症性心肌病的定义基于左心室(LV)收缩功能障碍,但两个心室均可受累。在这种情况下,越来越多的人认识到右心室(RV)收缩功能障碍与脓毒症患者的长期预后相关。与典型的SC不同,ST患者通常表现为左心室心尖部和心室中部圆周运动减弱以及基部收缩力增强。及时、准确地评估脓毒症患者的心脏功能障碍并非易事,但显然是必不可少的。关于脓毒症性心肌病的机制、评估和管理仍有必要进行进一步研究。

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