Heart failure related cardiogenic shock: An ISHLT consensus conference content summary.
Publication/Presentation Date
2-1-2024
Abstract
In recent years, there have been significant advancements in the understanding, risk-stratification, and treatment of cardiogenic shock (CS). Despite improved pharmacologic and device-based therapies for CS, short-term mortality remains as high as 50%. Most recent efforts in research have focused on CS related to acute myocardial infarction, even though heart failure related CS (HF-CS) accounts for >50% of CS cases. There is a paucity of high-quality evidence to support standardized clinical practices in approach to HF-CS. In addition, there is an unmet need to identify disease-specific diagnostic and risk-stratification strategies upon admission, which might ultimately guide the choice of therapies, and thereby improve outcomes and optimize resource allocation. The heterogeneity in defining CS, patient phenotypes, treatment goals and therapies has resulted in difficulty comparing published reports and standardized treatment algorithms. An International Society for Heart and Lung Transplantation (ISHLT) consensus conference was organized to better define, diagnose, and manage HF-CS. There were 54 participants (advanced heart failure and interventional cardiologists, cardiothoracic surgeons, critical care cardiologists, intensivists, pharmacists, and allied health professionals), with vast clinical and published experience in CS, representing 42 centers worldwide. State-of-the-art HF-CS presentations occurred with subsequent breakout sessions planned in an attempt to reach consensus on various issues, including but not limited to models of CS care delivery, patient presentations in HF-CS, and strategies in HF-CS management. This consensus report summarizes the contemporary literature review on HF-CS presented in the first half of the conference (part 1), while the accompanying document (part 2) covers the breakout sessions where the previously agreed upon clinical issues were discussed with an aim to get to a consensus.
Volume
43
Issue
2
First Page
189
Last Page
203
ISSN
1557-3117
Published In/Presented At
Kanwar, M. K., Billia, F., Randhawa, V., Cowger, J. A., Barnett, C. M., Chih, S., Ensminger, S., Hernandez-Montfort, J., Sinha, S. S., Vorovich, E., Proudfoot, A., Lim, H. S., Blumer, V., Jennings, D. L., Reshad Garan, A., Renedo, M. F., Hanff, T. C., Baran, D. A., & Consensus Conference participants (2024). Heart failure related cardiogenic shock: An ISHLT consensus conference content summary. The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation, 43(2), 189–203. https://doi.org/10.1016/j.healun.2023.09.014
Disciplines
Medicine and Health Sciences
PubMedID
38069920
Department(s)
Department of Medicine, Cardiology Division
Document Type
Article