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Sepsis is a multisystem disease process, which constitutes a significant public health challenge and is associated with high morbidity and mortality. Among other systems, sepsis is known to affect the cardiovascular system, which may manifest as myocardial injury, arrhythmias, refractory shock, and/or septic cardiomyopathy. Septic cardiomyopathy is defined as the reversible systolic and/or diastolic dysfunction of one or both ventricles. Left ventricle dysfunction has been extensively studied in the past, and its prognostic role in patients with sepsis is well documented. However, there is relatively scarce literature on right ventricle (RV) dysfunction and its role. Given the importance of timely detection of septic cardiomyopathy and its bearing on prognosis of patients, the role of RV dysfunction has come into renewed focus. Hence, through this review, we sought to describe the pathophysiology of RV dysfunction in sepsis and what have we learnt so far about its multifactorial nature. We also elucidate the roles of different biomarkers for its detection and prognosis, along with appropriate management of such patient population.
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http://dx.doi.org/10.1097/SHK.0000000000002120 | DOI Listing |
Chest
September 2025
Department of Critical Care Medicine, Respiratory Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, USA; Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA.
Topic Importance: Sepsis-induced cardiomyopathy (SICM) is a heterogeneous cardiovascular dysfunction associated with sepsis and septic shock. While traditionally defined by reversible left ventricular (LV) systolic dysfunction, recent evidence has revealed a broader spectrum, including LV diastolic dysfunction, hyperdynamic LV systolic states, and right ventricular (RV) injury, occurring independently or in combination. Despite their prognostic significance, these phenotypes remain underrecognized and understudied.
View Article and Find Full Text PDFArch Cardiovasc Dis
August 2025
Department of Cardiology, Georges-Pompidou European Hospital, université Paris Cité, 25, rue Leblanc, 75015 Paris, France. Electronic address:
Intensive Care Med Exp
August 2025
Department of Intensive Care, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles, 1070, Brussels, Belgium.
Dobutamine is the most commonly used inotropic agent in critically ill patients with impaired cardiac contractility. However, its benefit-risk profile remains debated, and clear, structured guidance for its use is lacking. This hypothesis proposes a pragmatic framework for dobutamine administration to promote rational and consistent clinical and experimental practice.
View Article and Find Full Text PDFNat Commun
August 2025
Department of Cardiology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
The metabolic flexibility of tissues determines the degree and reversibility of organ damage during inflammatory challenges. However, effective treatments for myocardial metabolic dysfunction in septic cardiomyopathy (SCM) are unavailable. Nicotinamide adenine dinucleotide-dependent signaling is fundamental to cellular metabolic homeostasis and inflammatory responses.
View Article and Find Full Text PDFBiomolecules
August 2025
Department of Surgery, University of Virginia, Charlottesville, VA 22903, USA.
Excessive formation of neutrophil extracellular traps (NETs) leads to NETosis, accompanied by the release of citrullinated histone H3 (CitH3), a key mediator of septic inflammation. However, the role of CitH3 in sterile inflammation, such as acute myocardial infarction (MI) and post-MI heart failure, remains incompletely understood. We investigated the role of CitH3, a byproduct of NETosis, in myocardial ischemia/reperfusion (I/R) injury using a murine MI model.
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