<b>Mapping the evidence on septic cardiomyopathy definition and its risk factors: a Scoping Review Protocol</b>

Septic cardiomyopathy (SCM) represents a serious and potentially reversible complication of sepsis, characterized by myocardial dysfunction that significantly contributes to morbidity and mortality(Hollenberg &amp; Singer, 2021). Despite its recognized clinical importance, SCM remains a diagnostic and therapeutic challenge, partly due to the lack of standardized and consensual definitions and diagnostic criteria (Zakynthinos et al., 2025). This lack of uniformity hinders the comparison of research studies, the interpretation of clinical outcomes, and ultimately, the optimization of patient management. Although progress has been made in understanding the pathophysiology and potential reversibility of myocardial dysfunction in the context of sepsis, the absence of a clear and universally accepted definition prevents the early and accurate identification of SCM, which may delay timely and effective interventions (Sivapathan et al., 2023).The need for clear definitions and diagnostic criteria is further underscored by the heterogeneity of SCM’s clinical manifestations. Patients may present with a wide spectrum of symptoms and signs, ranging from subtle alterations in cardiac biomarkers to severe myocardial dysfunction with hemodynamic instability(Beesley et al., 2018). This clinical variability, combined with the lack of uniform diagnostic criteria, complicates the distinction between SCM and other causes of cardiovascular dysfunction in the context of sepsis, such as stress-induced cardiomyopathy or preexisting myocardial dysfunction exacerbated by sepsis(Carbone et al., 2022).In addition to challenges in definition and diagnosis, the identification and understanding of risk factors associated with SCM remain crucial areas of investigation (Liang et al., 2021). While various factors, such as age, preexisting comorbidities, sepsis severity, and the nature of the infectious microorganism, have been explored, a comprehensive and consistent characterization of the risk factors predisposing individuals to SCM has yet to be achieved. This knowledge gap complicates the identification of high-risk individuals and, therefore, limits the implementation of targeted preventive strategies. Although some systematic reviews have addressed specific aspects of SCM, such as treatment, mortality, biomarkers, and the utility of strain echocardiography, no comprehensive synthesis has been conducted to cover the full scope of the issue.In this context, this scoping review is justified by the need to map and synthesize the available evidence regarding the definitions and risk factors of SCM in adults. This includes the evolution of definitions and diagnostic criteria over time and the identification of existing research gaps regarding risk factors. Specifically, this review seeks to answer the following key questions:1. What definitions and diagnostic criteria for septic cardiomyopathy are used in the scientific literature, and how have they evolved?2. What are the risk factors associated with septic cardiomyopathy, and what research gaps need to be addressed to improve understanding and standardization in this field?A preliminary search for scoping reviews and systematic reviews on the topic was conducted in the Joanna Briggs Institute (JBI) Evidence Synthesis, Cochrane Database of Systematic Reviews, CINAHL, PubMed, EPPI, and Epistemonikos databases on February 16th 2025. No scoping reviews on septic cardiomyopathy were identified. While some systematic reviews were found addressing specific aspects of SCM (treatment, mortality, biomarkers, strain echocardiography), none comprehensively addressed definitions, diagnostic criteria, and risk factors as a whole, nor analysed the evolution of definitions over time. Therefore, this scoping review will fill a significant gap in the literature by providing an exhaustive and up-to-date synthesis on the subject