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The role and research progress of ferroptosis in myocardial injury in sepsis

Jiayin Wang1,4,5,*, Sixu Chen2,5,*, Weiqi Lin3,4,*, Xinyi Xie1,5, Yutong Sun3,5, Qin Zhang3,5, Qixiang Xu1,4,5, Cuifeng Zhang2,5


1School of Pharmacology, Wannan Medical College, Wuhu, Anhui, China. 2School of Anesthesiology, Wannan  Medical College, Wuhu, Anhui, China. 3School of Clinical Medicine, Wannan Medical College, Wuhu, Anhui, China.  4Anesthesia Laboratory and Training Center, Wannan Medical College, Wuhu, Anhui, China. 5Wuhu Perioperative  Monitoring and Prognostic Technology Research and Development Center, Wannan Medical College, Wuhu, Anhui,  China. 

* The authors contribute equally and co-first authors.


Address correspondence to: Qixiang Xu, School of Pharmacology, Wannan Medical College, No. 22  Wenchang West Road, Yijiang District, Wuhu 241002, Anhui, China. Tel: +86-18355305112. E-mail:  xuqixiang@wnmc.edu.cn. Cuifeng Zhang, School of Anesthesiology, Wannan Medical College, No. 22  Wenchang West Road, Yijiang District, Wuhu 241002, Anhui, China. Tel: +86-15551257181. E-mail:  zhangcuifeng@wnmc.edu.cn.


Acknowledgement: This work was supported by The Foundation of Wannan Medical College (WK2023ZQNZ08), National university innovation and entrepreneurship training program (202310368014, 202310368049, 202410368014), Anhui Province university innovation and entrepreneurship training program (S202310368095, S202310368087, S202410368004, S202410368009).


DOI: https://doi.org/10.61189/691939hefazb


Received March 2, 2025; Accepted June 4, 2025; Published December 31, 2025


Highlights

● A comprehensive review of the role of ferroptosis in sepsis-induced myocardial injury is presented. 

● The mechanisms of ferroptosis and recent advancements in its involvement in sepsis-induced myocardial injury are discussed. 

● Perioperative whole-process risks may induce sepsis, activate ferroptosis and raise myocardial injury risk, while integrating ferroptosis into management can reduce this risk.

Abstract

Sepsis is triggered by the body's dysregulated response to infection, often accompanied by acute organ dysfunction and a high risk of mortality. The incidence of myocardial injury in sepsis patients ranges from 40% to 70%,  with complex pathophysiological mechanisms. In recent years, ferroptosis, a novel form of programmed cell death, has attracted widespread attention. Studies suggest that it may play a key role in sepsis-related myocardial injury; however, research in this field is still in the preliminary stage, with some controversial findings and unclear underlying mechanisms. Notably, risks throughout the perioperative period (preoperative stage, intraoperative trauma/infection, and postoperative recovery) can induce sepsis, which further activates the ferroptosis pathway and leads to myocardial injury. Based on this, integrating ferroptosis into the perioperative management system-optimizing risk stratification through marker screening and implementing targeted interventions-holds great significance for reducing the risk of perioperative sepsis-related myocardial injury. This article systematically summarizes the latest research progress on ferroptosis in sepsis-related myocardial injury, explores its potential mechanisms, and screens for potential therapeutic targets by combining the characteristics of perioperative risks, thereby providing references for subsequent clinical research and practice.

Keywords: Sepsis, myocardial injury, ferroptosis, perioperative period, research progress

Cite

Wang JY, Chen SX, Lin WQ, Xie XY, Sun YT, Zhang Q, Xu QX, Zhang CF. The role and research progress of ferroptosis in myocardial injury in sepsis. Perioper Precis Med. 2025 Dec; 2025; 3 (4): 176-185. doi: 10.61189/691939hefazb

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