What does this research mean for the field?

Right ventricular dysfunction is associated with increased 6-month mortality and worse hemodynamic stabilization in cardiogenic shock patients supported with Impella, but this association is not statistically significant in those supported with VA-ECMO. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the prevalence of right ventricular dysfunction and determine its association with 6-month mortality and hemodynamic stabilization in cardiogenic shock patients receiving temporary mechanical circulatory support.

September 12, 2026European Heart Journal OpenOpen Access

Right Ventricular Dysfunction in Cardiogenic Shock on Temporary Mechanical Circulatory Support

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Authors

JEJan Estoppey IMIulia Maia Muresan MBMatthias Bossard

Discussion

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Overview

Randomized trial demonstrates higher 6-month mortality with right ventricular dysfunction during Impella support for cardiogenic shock, highlighting the need for tailored device selection.

Key Points

To evaluate the prevalence of right ventricular dysfunction and determine its association with 6-month mortality and hemodynamic stabilization in cardiogenic shock patients receiving temporary mechanical circulatory support.
Interventional study analyzing 745 patients with cardiogenic shock from the SWISS Circulatory Support Registry (NCT04117230).
Compared outcomes between patients supported with left-side Impella devices (N=580, including 39 requiring a concomitant second device) and VA-ECMO (N=165).
Defined right ventricular dysfunction by TAPSE < 14 mm, TAPSE/sPAP < 0.34, RAP > 15 mmHg, RAP/PCWP > 0.63, or PAPi < 1.85, evaluating 6-month mortality and hemodynamic markers.
Right ventricular dysfunction occurred in 60% of patients on VA-ECMO compared to 33% of those supported with Impella (p < 0.001).
In Impella-treated patients, right ventricular dysfunction was associated with significantly higher 6-month mortality (43% vs. 30%, p = 0.015), higher lactate (1.6 vs. 1.3 mmol/L, p = 0.01), lower central venous oxygen saturation (55% vs. 61%, p = 0.005), and reduced mean arterial pressure (55 vs. 58 mmHg, p = 0.002).
In VA-ECMO patients, 6-month mortality was numerically higher with right ventricular dysfunction but did not achieve statistical significance (61% vs. 45%, p = 0.13).

Cite This Study

Estoppey et al. (2026) studied this question.

synapsesocial.com/papers/6aa51f39327956e4761f96d3 https://doi.org/10.1093/ehjopen/oeag139

View Full Paper

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September 12, 2026European Heart Journal OpenOpen Access

Right Ventricular Dysfunction in Cardiogenic Shock on Temporary Mechanical Circulatory Support

View Full Paper

Ask AI

Bookmark

Authors

JEJan Estoppey IMIulia Maia Muresan MBMatthias Bossard

Discussion

Member takes

Overview

Randomized trial demonstrates higher 6-month mortality with right ventricular dysfunction during Impella support for cardiogenic shock, highlighting the need for tailored device selection.

Key Points

To evaluate the prevalence of right ventricular dysfunction and determine its association with 6-month mortality and hemodynamic stabilization in cardiogenic shock patients receiving temporary mechanical circulatory support.
Interventional study analyzing 745 patients with cardiogenic shock from the SWISS Circulatory Support Registry (NCT04117230).
Compared outcomes between patients supported with left-side Impella devices (N=580, including 39 requiring a concomitant second device) and VA-ECMO (N=165).
Defined right ventricular dysfunction by TAPSE < 14 mm, TAPSE/sPAP < 0.34, RAP > 15 mmHg, RAP/PCWP > 0.63, or PAPi < 1.85, evaluating 6-month mortality and hemodynamic markers.
Right ventricular dysfunction occurred in 60% of patients on VA-ECMO compared to 33% of those supported with Impella (p < 0.001).
In Impella-treated patients, right ventricular dysfunction was associated with significantly higher 6-month mortality (43% vs. 30%, p = 0.015), higher lactate (1.6 vs. 1.3 mmol/L, p = 0.01), lower central venous oxygen saturation (55% vs. 61%, p = 0.005), and reduced mean arterial pressure (55 vs. 58 mmHg, p = 0.002).
In VA-ECMO patients, 6-month mortality was numerically higher with right ventricular dysfunction but did not achieve statistical significance (61% vs. 45%, p = 0.13).

Cite This Study

Estoppey et al. (2026) studied this question.

synapsesocial.com/papers/6aa51f39327956e4761f96d3 https://doi.org/10.1093/ehjopen/oeag139

View Full Paper

Ask AI

Bookmark