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Epidemiology, pathophysiology and contemporary management of cardiogenic shock – a position statement from the Heart Failure Association of the European Society of Cardiology

Chioncel, O; Parissis, J; Mebazaa, A; Thiele, H; Desch, S; Bauersachs, J; Harjola, V-P; Antohi, E-L; Arrigo, M; Gal, TB; et al. Chioncel, O; Parissis, J; Mebazaa, A; Thiele, H; Desch, S; Bauersachs, J; Harjola, V-P; Antohi, E-L; Arrigo, M; Gal, TB; Celutkiene, J; Collins, SP; DeBacker, D; Iliescu, VA; Jankowska, E; Jaarsma, T; Keramida, K; Lainscak, M; Lund, L; Lyon, AR; Masip, J; Metra, M; Miro, O; Mortara, A; Mueller, C; Mullens, W; Nikolaou, M; Piepoli, M; Price, S; Rosano, G; Vieillard-Baron, A; Weinstein, JM; Anker, SD; Filippatos, G; Ruschitzka, F; Coats, AJS; Seferovic, P (2020) Epidemiology, pathophysiology and contemporary management of cardiogenic shock – a position statement from the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail, 22 (8). pp. 1315-1341. ISSN 1879-0844 https://doi.org/10.1002/ejhf.1922
SGUL Authors: Rosano, Giuseppe Massimo Claudio

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Abstract

Cardiogenic Shock (CS) is a complex multifactorial clinical syndrome with extremely high mortality, developing as a continuum, and progressing from the initial insult (underlying cause) to the subsequent occurrence of organ failure and death. There is a large spectrum of CS presentations resulting from the interaction between an acute cardiac insult and a patient's underlying cardiac and overall medical condition. Phenotyping patients with CS may have clinical impact on management because classification would support initiation of appropriate therapies. CS management should consider appropriate organization of the healthcare services, and therapies must be given to the appropriately selected patients, in a timely manner, whilst avoiding iatrogenic harm. Although several consensus-driven algorithms have been proposed, CS management remains challenging and substantial investments in research and development have not yielded proof of efficacy and safety for most of the therapies tested, and outcome in this condition remains poor. Future studies should consider the identification of the new pathophysiological targets and high-quality translational research should facilitate incorporation of more targeted interventions in clinical research protocols, aimed to improve individual patient outcomes. Designing outcome clinical trials in CS remains particularly challenging in this critical and very costly scenario in cardiology, but information from these trials is imperiously needed to better inform the guidelines and clinical practice. The goal of this review is to summarize the current knowledge concerning the definition, epidemiology, underlying causes, pathophysiology and management of CS based on important lessons from clinical trials and registries, with focus on improving in-hospital management. This article is protected by copyright. All rights reserved.

Item Type: Article
Additional Information: This is the peer reviewed version of the following article: Chioncel, O., Parissis, J., Mebazaa, A., Thiele, H., Desch, S., Bauersachs, J., Harjola, V.‐P., Antohi, E.‐L., Arrigo, M., Gal, T.B., Celutkiene, J., Collins, S.P., DeBacker, D., Iliescu, V.A., Jankowska, E., Jaarsma, T., Keramida, K., Lainscak, M., Lund, L.H., Lyon, A.R., Masip, J., Metra, M., Miro, O., Mortara, A., Mueller, C., Mullens, W., Nikolaou, M., Piepoli, M., Price, S., Rosano, G., Vieillard‐Baron, A., Weinstein, J.M., Anker, S.D., Filippatos, G., Ruschitzka, F., Coats, A.J. and Seferovic, P. (2020), Epidemiology, pathophysiology and contemporary management of cardiogenic shock – a position statement from the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail, 22: 1315-1341., which has been published in final form at https://doi.org/10.1002/ejhf.1922. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. Correction available at https://doi.org/10.1002/ejhf.2152
Keywords: Cardiogenic Shock, Definition, Mechanical Circulatory Support, 1102 Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Eur J Heart Fail
ISSN: 1879-0844
Language: eng
Dates:
DateEvent
18 September 2020Published
16 July 2020Published Online
26 May 2020Accepted
Publisher License: Publisher's own licence
PubMed ID: 32469155
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/112086
Publisher's version: https://doi.org/10.1002/ejhf.1922

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