MicroRNAs as Regulators of Cardiac Dysfunction in Sepsis: Pathogenesis and Diagnostic Potential

Zhen Liu ¹ Feiyang Li ¹ Ningcen Li ¹ Yong Chen ^2* Zelin Chen ¹

• ¹ Tianjin University of Traditional Chinese Medicine, Tianjin, China
• ² Tianjin Hospital of ITCWM Nankai Hospital, Tianjin, China

Sepsis is a life-threatening disease resulting from an uncontrolled immune response to infection, leading to organ dysfunction. Severe inflammation can lead to multiple organ failures, significantly threatening human life and health. Myocardial dysfunction is a severe complication of sepsis that directly contributes to the high mortality rate. Studies have demonstrated various mechanisms, including mitochondrial dysfunction and oxidative stress, cardiomyocyte apoptosis and pyroptosis, dysregulated myocardial calcium homeostasis, inhibitory factors, dysregulation of the autonomic nervous system, hemodynamics, and myocardial structure, involved in the pathogenesis of sepsis-induced cardiac dysfunction (SIMD). MicroRNAs are crucial regulators of immune and normal cardiac function. This review focuses on the pathogenesis of SIMD and the role of microRNAs in SIMD. It summarizes the changes and molecular mechanisms of microRNAs in developing SIMD and discusses their potential applications in diagnosing SIMD. It has been found that microRNAs involved in developing SIMD can regulate mitochondrial function, oxidative stress, myocardial cell activity, apoptosis, pyroptosis, inflammatory reactions, myocardial fibrosis, and ferroptosis. In addition, many microRNAs that target SIMD are also involved in developing and treating other organ injuries associated with sepsis, such as lung injury, kidney injury, intestinal injury, liver injury, brain injury, and others. This review aims to provide a detailed summary of the role and mechanisms of microRNAs in SIMD.