Key result
Epigenetic pathways drive sepsis-induced cardiomyopathy and highlight emerging therapeutic targets.
Why the study?
Effective mechanism-based therapies for sepsis-induced cardiomyopathy remain unavailable due to its complex and heterogeneous pathophysiology, prompting interest in epigenetic regulation as a mechanistic link and therapeutic target.
Epigenetic remodeling provides a mechanistic framework linking septic stress to sustained myocardial dysfunction, highlighting the potential for biomarker-guided stratification and epigenetically targeted therapies in sepsis-induced cardiomyopathy.
Epigenetic targets in SICM remain hypothesis-generating; prospective trials needed before biomarker or therapeutic adoption.
Sepsis-induced cardiomyopathy (SICM) is a frequent and clinically important complication of sepsis, characterized by acute and often reversible myocardial dysfunction and associated with poor outcomes in critically ill patients. Despite growing recognition of its clinical significance, effective mechanism-based therapies remain unavailable, largely because SICM is highly heterogeneous and driven by a complex interplay of inflammatory activation, endothelial and microcirculatory dysfunction, oxidative stress, mitochondrial injury, calcium-handling abnormalities, metabolic reprogramming, and dynamic cardiomyocyte adaptation. In recent years, increasing attention has been directed toward epigenetic regulation, as it provides a mechanistic framework linking septic stress to sustained transcriptional and post-transcriptional remodeling in the myocardium and its immune microenvironment. Numerous studies have therefore investigated epigenetic mechanisms in SICM, including DNA methylation, histone modifications, and non-coding RNA-mediated regulation. This review summarizes recent advances in the understanding of epigenetic mechanisms underlying SICM, with emphasis on their roles in inflammation, mitochondrial dysfunction, immune–cardiac crosstalk, and cardiomyocyte injury. We further discuss the translational relevance of epigenetic remodeling and highlight the emerging therapeutic potential of epigenetically targeted interventions. Collectively, these findings provide important mechanistic insights into SICM and may support the development of biomarker-guided stratification and more precise therapeutic strategies for septic myocardial dysfunction.
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Jiang et al. (2026) conducted a review in Sepsis-induced cardiomyopathy. Epigenetic mechanisms (DNA methylation, histone modifications, non-coding RNAs) was evaluated. Epigenetic mechanisms, including DNA methylation, histone modifications, and non-coding RNAs, drive the pathophysiology of sepsis-induced cardiomyopathy and offer emerging therapeutic targets.
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