Epidemiology, pathophysiology and contemporary management of cardiogenic shock – a position statement from the Heart Failure Association of the European Society of Cardiology
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- Ovidiu Chioncel
- Emergency Institute for Cardiovascular Diseases ‘Prof. C.C. Iliescu’ Bucharest Romania
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- John Parissis
- Heart Failure Unit, Department of Cardiology Attikon University Hospital Athens Greece
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- Alexandre Mebazaa
- University of Paris Diderot, Hôpitaux Universitaires Saint Louis Lariboisière, APHP Paris France
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- Holger Thiele
- Department of Internal Medicine/Cardiology Heart Center Leipzig at University of Leipzig Leipzig Germany
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- Steffen Desch
- Department of Internal Medicine/Cardiology Heart Center Leipzig at University of Leipzig Leipzig Germany
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- Johann Bauersachs
- Department of Cardiology & Angiology, Hannover Medical School Hannover Germany
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- Veli‐Pekka Harjola
- Emergency Medicine University of Helsinki, Helsinki University Hospital Helsinki Finland
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- Elena‐Laura Antohi
- Emergency Institute for Cardiovascular Diseases ‘Prof. C.C. Iliescu’ Bucharest Romania
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- Mattia Arrigo
- Department of Cardiology University Hospital Zurich Zurich Switzerland
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- Tuvia Ben Gal
- Department of Cardiology, Rabin Medical Center Petah Tiqwa Israel
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- Jelena Celutkiene
- Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Medical Faculty of Vilnius University Vilnius Lithuania
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- Sean P. Collins
- Department of Emergency Medicine Vanderbilt University School of Medicine Nashville TN USA
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- Daniel DeBacker
- Department of Intensive Care CHIREC Hospitals, Université Libre de Bruxelles Brussels Belgium
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- Vlad A. Iliescu
- Emergency Institute for Cardiovascular Diseases ‘Prof. C.C. Iliescu’ Bucharest Romania
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- Ewa Jankowska
- Department of Heart Disease Wroclaw Medical University, University Hospital, Center for Heart Disease Wroclaw Poland
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- Tiny Jaarsma
- Department of Health, Medicine and Health Sciences Linköping University Linköping Sweden
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- Kalliopi Keramida
- National Kapodistrian University of Athens Medical School Athens Greece
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- Mitja Lainscak
- Division of Cardiology, General Hospital Murska Sobota Murska Sobota Slovenia
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- Lars H Lund
- Heart and Vascular Theme, Karolinska University Hospital Stockholm Sweden
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- Alexander R. Lyon
- Imperial College London National Heart & Lung Institute London UK
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- Josep Masip
- Consorci Sanitari Integral, University of Barcelona Barcelona Spain
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- Marco Metra
- Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health University of Brescia Brescia Italy
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- Oscar Miro
- Emergency Department Hospital Clinic, Institut d'Investigació Biomèdica August Pi iSunyer (IDIBAPS) Barcelona Spain
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- Andrea Mortara
- Department of Cardiology Policlinico di Monza Monza Italy
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- Christian Mueller
- Department of Cardiology and Cardiovascular Research Institute Basel (CRIB) University Hospital Basel Basel Switzerland
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- Wilfried Mullens
- Department of Cardiology Ziekenhuis Oost Genk Belgium
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- Maria Nikolaou
- Heart Failure Unit, Department of Cardiology Attikon University Hospital Athens Greece
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- Massimo Piepoli
- Heart Failure Unit, Cardiology, Emergency Department Guglielmo da Saliceto Hospital, Piacenza, University of Parma; Institute of Life Sciences, Sant'Anna School of Advanced Studies Pisa Italy
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- Susana Price
- Royal Brompton Hospital & Harefield NHS Foundation Trust London UK
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- Giuseppe Rosano
- Centre for Clinical and Basic Research, Department of Medical Sciences, IRCCS San Raffaele Pisana Rome Italy
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- Antoine Vieillard‐Baron
- INSERM U‐1018, CESP, Team 5 (EpReC, Renal and Cardiovascular Epidemiology), UVSQ Villejuif France
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- Jean M. Weinstein
- Cardiology Department Soroka University Medical Centre Beer Sheva Israel
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- Stefan D. Anker
- Department of Cardiology (CVK) Berlin Institute of Health Center for Regenerative Therapies (BCRT); German Centre for Cardiovascular Research (DZHK) partner site Berlin Berlin Germany
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- Gerasimos Filippatos
- University of Athens, Heart Failure Unit, Attikon University Hospital Athens Greece
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- Frank Ruschitzka
- Department of Cardiology University Hospital Zurich Zurich Switzerland
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- Andrew J.S. Coats
- Pharmacology, Centre of Clinical and Experimental Medicine IRCCS San Raffaele Pisana Rome Italy
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- Petar Seferovic
- Faculty of Medicine University of Belgrade Belgrade, Serbia;
説明
<jats:title>Abstract</jats:title><jats:p>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 health care 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 a focus on improving in‐hospital management.</jats:p>
収録刊行物
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- European Journal of Heart Failure
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European Journal of Heart Failure 22 (8), 1315-1341, 2020-07-16
Wiley