Sepsis associated cardiomyopathy

SummaryThe incidence and frequency of sepsis is continuously increasing, due to the aging of the population, increase of patients with compromised immune systems, and of patients undergoing prolonged, high-risk surgery. Sepsis is the result of complex interactions among the infecting microorganism and the host immune, inflammatory, and coagulation responses. Myocardial dysfunction is a common complication in patients with severe sepsis. Initially considered as a preterminal sign, it is now recognized as one of the most important features of severe sepsis and of septic shock. Early recognition and aggressive supportive therapy of sepsis associated myocardial dysfunction are important in order to reduce the mortality of patients with septic shock. Recently some biochemical measurements such as troponins and natriuretic peptides have been recognised and popularised as early markers of myocardial dysfunction. This review aims to identify the keypoints in the pathophysiological and clinical manifestationa of myocardial dysfunction associated with sepsis, and their relevance to diagnostic work-up.