Key result
Cardiogenic shock from AMI presents with ~23% lower SVRi than shock from ADHF.
Why the study?
The pathophysiology of cardiogenic shock varies by etiology, which may lead to different hemodynamic profiles and help tailor therapy.
Do hemodynamic profiles differ between cardiogenic shock secondary to acute myocardial infarction versus acute decompensated chronic heart failure?
Observational (n=28)
Do hemodynamic profiles differ between cardiogenic shock secondary to acute myocardial infarction versus acute decompensated chronic heart failure?
Cardiogenic shock secondary to AMI presents with lower systemic vascular resistance and a trend toward higher cardiac index compared to shock from acute decompensated heart failure, suggesting etiology-specific hemodynamic profiles.
Supports etiology-specific hemodynamics in cardiogenic shock; hypothesis-generating for tailored management pending prospective validation.
The pathophysiology of cardiogenic shock (CS) varies depending on its etiology, which may lead to different hemodynamic profiles (HP) and may help tailor therapy. We aimed to assess the HP of CS patients according to their etiologies of acute myocardial infarction (AMI) and acute decompensated chronic heart failure (ADCHF). We included patients admitted for CS secondary to ADCHF and AMI. HP were measured before the administration of any inotrope or vasopressor. Systemic Vascular Resistances index (SVRi), Cardiac Index (CI), and Cardiac Power Index (CPI) were measured by trans-thoracic Doppler echocardiography on admission. Among 37 CS patients, 28 had CS secondary to ADCHF or AMI and were prospectively included. The two groups were similar in terms of demographic data and shock severity criteria. AMI CS was associated with lower SVRi compared to CS related to ADCHF: 2010 (interquartile range (IQR): 1895–2277) vs. 2622 (2264–2993) dynes-s·cm−5·m−2 (p = 0.002). A trend toward a higher CI was observed: respectively 2.13 (1.88–2.18) vs. 1.78 (1.65–1.96) L·min−1·m−2 (p = 0.067) in AMICS compared to ADCHF. CS patients had different HP according to their etiologies. AMICS had lower SVR and tended to have a higher CI compared to ADHF CS. These differences should be taken into account for patient selection in future research.
No takes yet. Share an insight, caveat, or question.
Gaubert et al. (2020) conducted an observational in Cardiogenic shock (n=28). Acute myocardial infarction (AMI) etiology vs. Acute decompensated chronic heart failure (ADCHF) etiology was evaluated on Systemic Vascular Resistances index (SVRi) (p=0.002). Cardiogenic shock from acute myocardial infarction had a lower systemic vascular resistance index than shock from acute decompensated heart failure (2010 vs 2622 dynes-s·cm−5·m−2; p=0.002).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: