Palacios Ordonez Cesar, Garan Arthur Reshad
Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Curr Opin Cardiol. 2022 May 1;37(3):236-240. doi: 10.1097/HCO.0000000000000957. Epub 2022 Mar 11.
Despite novel technologies for treating shock patients, cardiogenic shock mortality remains high. Trends of cardiogenic shock associated with acute myocardial infarction (AMI) have previously been described, though little is known about cardiogenic shock resulting from other causes, which has progressively been documented as a distinct entity from AMI-cardiogenic shock. Herein, we review the evolving epidemiology, novel classification schema, and future perspectives of cardiogenic shock.
While AMI or mechanical complications of AMI are the most common causes, the incidence of etiologies of cardiogenic shock not related to AMI, particularly acute on chronic heart failure, may be increasing, with a growing burden of noncoronary structural heart disease.
Mortality in cardiogenic shock remains high. Overall, these findings highlight the need to address the lack of effective treatments in this field, particularly for cardiogenic shock caused by diseases other than AMI. Novel classification systems may facilitate cardiogenic shock research.
尽管有治疗休克患者的新技术,但心源性休克的死亡率仍然很高。此前已有关于与急性心肌梗死(AMI)相关的心源性休克的趋势描述,不过对于其他原因导致的心源性休克了解甚少,后者已逐渐被确认为与AMI心源性休克不同的实体。在此,我们综述心源性休克不断演变的流行病学、新的分类模式及未来展望。
虽然AMI或AMI的机械并发症是最常见的病因,但与AMI无关的心源性休克病因的发生率,尤其是慢性心力衰竭急性发作,可能在增加,非冠状动脉性结构性心脏病的负担也在加重。
心源性休克的死亡率仍然很高。总体而言,这些发现凸显了该领域缺乏有效治疗方法的问题,尤其是对于由AMI以外的疾病引起的心源性休克。新的分类系统可能会促进心源性休克的研究。