Heart failure related cardiogenic shock: An ISHLT consensus conference content summary

Manreet K. Kanwar, Filio Billia, Varinder Randhawa, Jennifer A. Cowger, Christopher M. Barnett, Sharon Chih, Stephan Ensminger, Jaime Hernandez-Montfort, Shashank S. Sinha, Esther Vorovich, Alastair Proudfoot, Hoong S. Lim, Vanessa Blumer, Douglas L. Jennings, A. Reshad Garan, Maria F. Renedo, Thomas C. Hanff, David A. Baran, Chris Overgaard, Jeffrey TeutebergCarolyn Rosner, Dave Nagpal, Ziad Taimeh, Jacob Abraham, Van Khue Ton, Stavros Drakos, Behnam Tehrani, Alexander Bernhardt, Talha Meeran, P. Douglas Greig, Marta Farrero, Jason Katz, Adriana Luk, Courtney Bennett, Alejandro Bertolotti, Ryan J. Tedford, Rebecca Cogswell, Liviu Klein, Cesar Y. Guerrero-Miranda, Penelope Rampersad, Luciano Potena, Udo Boeken, Hannah Copeland, Shelley Hall, José González-Costello, Navin K. Kapur, Antonio Loforte, Daniel Burkhoff, Pascal LePrince, Finn Gustafsson, Nir Uriel, Rachna Kataria, Sonali Arora, Marco Masetti, Diyar Saeed

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)189-203
Number of pages15
JournalJournal of Heart and Lung Transplantation
Volume43
Issue number2
DOIs
StatePublished - Feb 2024

Bibliographical note

Publisher Copyright:
© 2023 International Society for the Heart and Lung Transplantation

Keywords

  • cardiogenic shock
  • consensus statement
  • global perspective
  • heart failure shock
  • mechanical circulatory support

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