Disfunzione miocardica in corso di sepsi: Epidemiologia, significato prognostico e trattamento

Translated title of the contribution: Myocardial dysfunction during sepsis: Epidemiology, prognostic significance and treatment

Giorgia Paoli, Serafina Valente, Diego Ardissino, Gian Franco Gensini

Research output: Contribution to journalArticlepeer-review

Abstract

About 50% of patients with sepsis show myocardial involvement characterized by biventricular enlargement, reduced contractility and diastolic dysfunction. This increases the risk of death and leads to an extremely poor prognosis in the case of severe sepsis or septic shock, with full recovery of cardiac function seen in survivors at 7-10 days. The pathogenesis of myocardial dysfunction has long been investigated and, although it is still not fully understood, seems not to be due to reduced coronary flow, but to circulating substances released by pathogens (e.g. endotoxins) and host immuno-inflammatory responses (e.g. cytokines and mechanisms related to nitric oxide). First-line therapy is causal and consists of antibiotics plus the surgical excision of the infectious focus; in the presence of severe sepsis or septic shock, it is also necessary to promptly start circulatory and multiorgan support treatment. This review describes current knowledge concerning the instrumental and clinical characteristics, pathophysiology, prognosis and therapy of myocardial dysfunction during sepsis, and briefly considers possible future therapeutic perspectives.

Translated title of the contributionMyocardial dysfunction during sepsis: Epidemiology, prognostic significance and treatment
Original languageItalian
Pages (from-to)804-814
Number of pages11
JournalGiornale Italiano di Cardiologia
Volume12
Issue number12
DOIs
Publication statusPublished - Dec 2011

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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