Research advances in the role of macrophages in the pathogenesis and treatment of sepsis-induced cardiomyopathy

Sepsis-induced cardiomyopathy (SIC) is a form of myocardial dysfunction induced by sepsis, which significantly increases mortality in septic patients. Its pathogenic mechanisms are highly complex, and there is currently no targeted treatment strategy. Macrophages (MΦ), as the most abundant immune cells in the heart, play an important role in the initiation, progression, and repair of SIC due to their high heterogeneity. Therefore, this review systematically summarizes the origin and function of cardiac MΦ and explores their potential pathways in the pathogenesis of SIC. Additionally, it highlights recent research advances in mitigating post-septic cardiac dysfunction and tissue damage by targeting the inhibition of inflammatory MΦ recruitment, specifically regulating MΦ inflammatory polarization and metabolic reprogramming, thus enhancing the activity of reparative MΦ. This review provides a theoretical basis for targeting MΦ in the prevention and treatment of SIC.