期刊
JACC-HEART FAILURE
卷 8, 期 11, 页码 879-891出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.jchf.2020.09.005
关键词
acute decompensated heart failure; acute myocardial infarction; cardiogenic shock; mechanical circulatory support; multidisciplinary care
资金
- Pepper Scholars Program of the Johns Hopkins University Claude D. Pepper Older Americans Independence Center - National Institute on Aging [P30-AG021334]
Cardiogenic shock is a hemodynamically complex syndrome characterized by a low cardiac output that often culminates in multiorgan system failure and death. Despite recent advances, clinical outcomes remain poor, with mortality rates exceeding 40%. In the absence of adequately powered randomized controlled trials to guide therapy, best practices for shock management remain nonuniform. Emerging data from North American registries, however, support the use of standardized protocols focused on rapid diagnosis, early intervention, ongoing hemodynamic assessment, and multidisciplinary longitudinal care. In this review, the authors examine the pathophysiology and phenotypes of cardiogenic shock, benefits and limitations of current therapies, and they propose a standardized and team-based treatment algorithm. Lastly, they discuss future research opportunities to address current gaps in clinical knowledge. (C) 2020 by the American College of Cardiology Foundation.
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