Chapter 14
The Management of Cardiogenic Shock and Hemodynamic Support Devices and Techniques
Bimmer Claessen,
José P.S. Henriques,
Bimmer Claessen
Search for more papers by this authorJosé P.S. Henriques
Search for more papers by this authorBimmer Claessen,
José P.S. Henriques,
Bimmer Claessen
Search for more papers by this authorJosé P.S. Henriques
Search for more papers by this authorBook Editor(s):George D. Dangas MD, MACC, MSCAI, FAHA, FESC,
Carlo Di Mario MD, PhD, FRCP, FACC, FSCAI, FESC,
Holger Thiele MD,
Peter Barlis MBBS, MPH, PHD, FACC, FESC, FRACP,
Tayo Addo MD, Bimmer Claessen MD, Christian Hengstenberg MD, Nicholas Kipshidze MD,
George D. Dangas MD, MACC, MSCAI, FAHA, FESC
Professor of Medicine (Cardiology) & Surgery (Vascular) Professor of Cardiology Adjunct Professor of Internal Medicine
Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, New York, NY, USA
National Kapodistrian University of Athens, Greece
Medical University of Vienna, Austria
Search for more papers by this authorCarlo Di Mario MD, PhD, FRCP, FACC, FSCAI, FESC
Professor of Cardiology Director of the Structural Interventional Cardiology Division Honorary Consultant
University of Florence
University Hospital Careggi, Florence, Italy
Cardiologist Royal Brompton Hospital, London, UK
Search for more papers by this authorHolger Thiele MD
Professor of Cardiology at University of Leipzig
Heart Center Leipzig at University of Leipzig, Leipzig, Germany
Search for more papers by this authorPeter Barlis MBBS, MPH, PHD, FACC, FESC, FRACP
Professor of Cardiology Interventional Cardiologist
University of Melbourne, Melbourne, Victoria, Australia
St Vincent's & Northern Hospitals Victoria, Australia
Search for more papers by this authorSummary
Cardiogenic shock is defined as a clinical condition where there is inadequate end-organ perfusion due to failure of the heart to pump blood in adequate quantities. Prolonged tissue hypoperfusion may lead to end-organ damage, multi-organ failure, and often death. The incidence of cardiogenic shock after myocardial infarction appears to be lowering from about 10% in the 1970s and 80s to about 5–6% in the current era, potentially as a result of improvement in time-to-reperfusion and as a result of better techniques for reperfusion (primary percutaneous coronary intervention compared with thrombolysis). Nonetheless, mortality after cardiogenic shock remains as high as 50% in contemporary cohorts. The management of cardiogenic shock includes the judicious use of several mechanical circulatory support devices.
References
- Hochman JS , Sleeper LA , Webb JG , et al . Early revascularization in acute myocardial infarction complicated by cardiogenic shock. SHOCK Investigators. Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock . New Engl J Med. 1999 ; 341 ( 9 ): 625 – 34 .
- Hochman JS , Sleeper LA , Godfrey E , et al . SHould we emergently revascularize Occluded Coronaries for cardiogenic shocK: an international randomized trial of emergency PTCA/CABG-trial design. The SHOCK Trial Study Group . Am Heart J. 1999 ; 137 ( 2 ): 313 – 21 .
- Thiele H , Schuler G , Neumann FJ , et al . Intraaortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock: design and rationale of the Intraaortic Balloon Pump in Cardiogenic Shock II (IABP-SHOCK II) trial . Am Heart J. 2012 ; 163 ( 6 ): 938 – 45 .
- Thiele H , Akin I , Sandri M , et al . PCI Strategies in Patients with Acute Myocardial Infarction and Cardiogenic Shock . N Engl J Med. 2017 ; 377 ( 25 ): 2419 – 32 .
- Baran DA , Grines CL , Bailey S , et al . SCAI clinical expert consensus statement on the classification of cardiogenic shock: This document was endorsed by the American College of Cardiology (ACC), the American Heart Association (AHA), the Society of Critical Care Medicine (SCCM), and the Society of Thoracic Surgeons (STS) in April 2019 . Catheter Cardiovasc Interv. 2019 ; 94 ( 1 ): 29 – 37 .
- Hands ME , Rutherford JD , Muller JE , et al . The in-hospital development of cardiogenic shock after myocardial infarction: incidence, predictors of occurrence, outcome and prognostic factors. The MILIS Study Group . J Am Coll Cardiol. 1989 ; 14 ( 1 ): 40 – 6 ; discussion 7–8.
- Goldberg RJ , Samad NA , Yarzebski J , et al . Temporal trends in cardiogenic shock complicating acute myocardial infarction . N Engl J Med. 1999 ; 340 ( 15 ): 1162 – 8 .
- Babaev A , Frederick PD , Pasta DJ , et al . Trends in management and outcomes of patients with acute myocardial infarction complicated by cardiogenic shock . JAMA. 2005 ; 294 ( 4 ): 448 – 54 .
- Jeger RV , Radovanovic D , Hunziker PR , et al . Ten-year trends in the incidence and treatment of cardiogenic shock . Annals of Int Med. 2008 ; 149 ( 9 ): 618 – 26 .
- Goldberg RJ , Spencer FA , Gore JM , et al . Thirty-year trends (1975 to 2005) in the magnitude of, management of, and hospital death rates associated with cardiogenic shock in patients with acute myocardial infarction: a population-based perspective . Circulation. 2009 ; 119 ( 9 ): 1211 – 9 .
- Thiele H , Zeymer U , Neumann FJ , et al . Intra-aortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock (IABP-SHOCK II): final 12 month results of a randomised, open-label trial . The Lancet. 2013 ; 382 ( 9905 ): 1638 – 45 .
- French JK , Armstrong PW , Cohen E , et al . Cardiogenic shock and heart failure post-percutaneous coronary intervention in ST-elevation myocardial infarction: observations from “Assessment of Pexelizumab in Acute Myocardial Infarction” . Am Heart J. 2011 ; 162 ( 1 ): 89 – 97 .
- Hasdai D , Califf RM , Thompson TD , et al . Predictors of cardiogenic shock after thrombolytic therapy for acute myocardial infarction . J Am Coll Cardiol. 2000 ; 35 ( 1 ): 136 – 43 .
- American College of Emergency P, Society for Cardiovascular A, Interventions , O'Gara PT , Kushner FG , Ascheim DD , et al . 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines . J Am Coll Cardiol. 2013 ; 61 ( 4 ): e78 – 140 .
- Sleeper LA , Ramanathan K , Picard MH , et al . Functional status and quality of life after emergency revascularization for cardiogenic shock complicating acute myocardial infarction . J Am Coll Cardiol. 2005 ; 46 ( 2 ): 266 – 73 .
- White HD , Assmann SF , Sanborn TA , et al . Comparison of percutaneous coronary intervention and coronary artery bypass grafting after acute myocardial infarction complicated by cardiogenic shock: results from the Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock (SHOCK) trial . Circulation. 2005 ; 112 ( 13 ): 1992 – 2001 .
- Thiele H , Akin I , Sandri M , et al . One-Year Outcomes after PCI Strategies in Cardiogenic Shock . N Engl J Med. 2018 ; 379 ( 18 ): 1699 – 710 .
- Neumann FJ , Sousa-Uva M , Ahlsson A , et al . 2018 ESC/EACTS Guidelines on myocardial revascularization . Eur Heart J. 2019 ; 40 ( 2 ): 87 – 165 .
- Ouweneel DM , Henriques JP . Percutaneous cardiac support devices for cardiogenic shock: current indications and recommendations . Heart. 2012 ; 98 ( 16 ): 1246 – 54 .
- Prondzinsky R , Unverzagt S , Russ M , et al . Hemodynamic effects of intra-aortic balloon counterpulsation in patients with acute myocardial infarction complicated by cardiogenic shock: the prospective, randomized IABP shock trial . Shock. 2012 ; 37 ( 4 ): 378 – 84 .
- Thiele H , Zeymer U , Neumann FJ , et al . Intraaortic balloon support for myocardial infarction with cardiogenic shock . N Engl J Med. 2012 ; 367 ( 14 ): 1287 – 96 .
- Seyfarth M , Sibbing D , Bauer I , et al . A randomized clinical trial to evaluate the safety and efficacy of a percutaneous left ventricular assist device versus intra-aortic balloon pumping for treatment of cardiogenic shock caused by myocardial infarction . J Am Coll Cardiol. 2008 ; 52 ( 19 ): 1584 – 8 .
- Engstrom AE , Cocchieri R , Driessen AH , et al . The Impella 2.5 and 5.0 devices for ST-elevation myocardial infarction patients presenting with severe and profound cardiogenic shock: the Academic Medical Center intensive care unit experience . Critical Care Medicine. 2011 ; 39 ( 9 ): 2072 – 9 .
- O'Neill WW , Schreiber T , Wohns DH , et al . The current use of Impella 2.5 in acute myocardial infarction complicated by cardiogenic shock: results from the USpella Registry . Journal of Interventional Cardiology. 2014 ; 27 ( 1 ): 1 – 11 .
- Dhruva SS , Ross JS , Mortazavi BJ , et al . Association of Use of an Intravascular Microaxial Left Ventricular Assist Device vs Intra-aortic Balloon Pump With In-Hospital Mortality and Major Bleeding Among Patients With Acute Myocardial Infarction Complicated by Cardiogenic Shock . JAMA . 2020 .
- Amin AP , Spertus JA , Curtis JP , et al . The Evolving Landscape of Impella Use in the United States Among Patients Undergoing Percutaneous Coronary Intervention With Mechanical Circulatory Support . Circulation. 2020 ; 141 ( 4 ): 273 – 84 .
- Ouweneel DM , Eriksen E , Sjauw KD , et al . Percutaneous Mechanical Circulatory Support Versus Intra-Aortic Balloon Pump in Cardiogenic Shock After Acute Myocardial Infarction . J Am Coll Cardiol. 2017 ; 69 ( 3 ): 278 – 87 .
- Udesen NJ , Moller JE , Lindholm MG , et al . Rationale and design of DanGer shock: Danish-German cardiogenic shock trial . Am Heart J. 2019 ; 214 : 60 – 8 .
- Burkhoff D , Cohen H , Brunckhorst C , O'Neill WW , TandemHeart Investigators G. A randomized multicenter clinical study to evaluate the safety and efficacy of the TandemHeart percutaneous ventricular assist device versus conventional therapy with intraaortic balloon pumping for treatment of cardiogenic shock . Am Heart J. 2006 ; 152 ( 3 ): 469 e1 – 8 .
- Thiele H , Sick P , Boudriot E , et al . Randomized comparison of intra-aortic balloon support with a percutaneous left ventricular assist device in patients with revascularized acute myocardial infarction complicated by cardiogenic shock . Eur Heart J. 2005 ; 26 ( 13 ): 1276 – 83 .
- Lamhaut L , Hutin A , Puymirat E , et al . A Pre-Hospital Extracorporeal Cardio Pulmonary Resuscitation (ECPR) strategy for treatment of refractory out hospital cardiac arrest: An observational study and propensity analysis . Resuscitation. 2017 ; 117 : 109 – 17 .
- Ostadal P , Rokyta R , Kruger A , et al . Extra corporeal membrane oxygenation in the therapy of cardiogenic shock (ECMO-CS): rationale and design of the multicenter randomized trial . Eur J Heart Fail. 2017 ; 19 Suppl 2 : 124 – 7 .
- Authors/Task Force m , Windecker S , Kolh P , Alfonso F , Collet JP , Cremer J , et al. 2014 ESC/EACTS Guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI) . Eur Heart J. 2014 ; 35 ( 37 ): 2541 – 619 .
- Horwitz D , Fox Sm D , Goldberg LI . Effects of Dopamine in man . Circulation Research. 1962 ; 10 : 237 – 43 .
- Dasta JF , Kirby MG . Pharmacology and therapeutic use of low-dose dopamine . Pharmacotherapy. 1986 ; 6 ( 6 ): 304 – 10 .
- De Backer D , Biston P , Devriendt J , et al . Comparison of dopamine and norepinephrine in the treatment of shock . N Engl J Med. 2010 ; 362 ( 9 ): 779 – 89 .
- Baim DS , McDowell AV , Cherniles J , et al . Evaluation of a new bipyridine inotropic agent--milrinone--in patients with severe congestive heart failure . N Engl J Med. 1983 ; 309 ( 13 ): 748 – 56 .
- Yokoshiki H , Katsube Y , Sunagawa M , Sperelakis N . Levosimendan, a novel Ca2+ sensitizer, activates the glibenclamide-sensitive K+ channel in rat arterial myocytes . European Journal of Pharmacology. 1997 ; 333 ( 2–3 ): 249 – 59 .
- Pollesello P , Ovaska M , Kaivola J , et al . Binding of a new Ca2+ sensitizer, levosimendan, to recombinant human cardiac troponin C. A molecular modelling, fluorescence probe, and proton nuclear magnetic resonance study . J Biol Chem. 1994 ; 269 ( 46 ): 28584 – 90 .
- O'Neill W , Basir M , Dixon S , et al . Feasibility of Early Mechanical Support During Mechanical Reperfusion of Acute Myocardial Infarct Cardiogenic Shock . JACC Cardiovasc Interv. 2017 ; 10 ( 6 ): 624 – 5 .
- Saltzman AJ , Paz YE , Rene AG , et al . Comparison of surgical pericardial drainage with percutaneous catheter drainage for pericardial effusion . J Invasive Cardiol. 2012 ; 24 ( 11 ): 590 – 3 .
