Septic cardiomyopathy: a narrative review ; Cardiomiopatia da sepsis: uma revisão narrativa

© 2023 Sociedade Portuguesa de Cardiologia. Published by Elsevier Espa˜na, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). ; Sepsis is a systemic inflammatory response syndrome of suspected or documented infectious origin, whose outcome is multiorgan failure. Sepsis-induced myocardial dysfunction (SIMD), present in more than 50% of septic patients, is characterized by (i) left ventricular (LV) dilatation with normal or low filling pressure, (ii) right and/or LV (systolic and/or diastolic) dysfunction and (iii) reversibility. Since the first definition proposed by Parker et al. in 1984, attempts have been made to define SIMD. Many parameters are used to assess cardiac function in septic patients, sometimes making it more difficult to measure due to the intrinsic hemodynamical changes in this condition. Nevertheless, with advanced echocardiographic techniques, such as speckle tracking analysis, it is possible to diagnose and assess systolic and diastolic dysfunction, even in the earliest stages of sepsis. Cardiac magnetic resonance imaging brings new insights into the reversibility of this condition. Many uncertainties still remain regarding the mechanisms, characteristics, treatment and even prognosis of this condition. There are also inconsistent conclusions from studies, therefore this review attempts to summarize our current knowledge of SIMD. ; Sépsis é uma síndrome de resposta inflamatória sistémica de origem infecciosa, suspeita ou documentada, cujo resultado é falência multiorgânica. Disfunção miocárdica induzida por sépsis (SIMD), presente em mais de 50% dos doentes com sépsis, é caracterizada por (i) dilatação ventricular esquerda com pressão de preenchimento normal ou baixa, (ii) disfunção ventricular direita e/ou esquerda (sistólica e/ou diastólica) e (iii) reversibilidade. Ao longo dos anos, houve tentativas de definir SIMD, desde a primeira definição proposta por Parker et al. em 1984 até à atual era tecnológica. Há vários ...