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临时机械循环支持在伴有心源性休克的心力衰竭综合征中的作用:当代综述。

The role of temporary mechanical circulatory support in heart failure syndromes with cardiogenic shock: A contemporary review.

作者信息

Eftychiou Stavros, Kalakoutas Antonis, Proudfoot Alastair

机构信息

Barts Health NHS Trust, London E1 1FR, UK.

Barking, Havering and Redbridge University Hospitals NHS Trust, Romford RM7 0AG, UK.

出版信息

J Intensive Med. 2022 Nov 29;3(2):89-103. doi: 10.1016/j.jointm.2022.10.002. eCollection 2023 Apr 30.

Abstract

Cardiogenic shock (CS) is a complex clinical syndrome with a high mortality rate. It can occur to due to multiple etiologies of cardiovascular disease and is phenotypically heterogeneous. Acute myocardial infarction-related CS (AMI-CS) has historically been the most prevalent cause, and thus, research and guidance have focused primarily on this. Recent data suggest that the burden of non-ischemic CS is increasing in the population of patents requiring intensive care admission. There is, however, a paucity of data and guidelines to inform the management of these patients who fall into two broad groups: those with existing heart failure and CS and those with no known history of heart failure who present with "" CS. The use of temporary mechanical circulatory support (MCS) has expanded across all etiologies, despite its high cost, resource intensity, complication rates, and lack of high-quality outcome data. Herein, we discuss the currently available evidence on the role of MCS in the management of patients with CS to include fulminant myocarditis, right ventricular (RV) failure, Takotsubo syndrome, post-partum cardiomyopathy, and CS due to valve lesions and other cardiomyopathies.

摘要

心源性休克(CS)是一种死亡率很高的复杂临床综合征。它可由多种心血管疾病病因引起,且表型具有异质性。急性心肌梗死相关的心源性休克(AMI-CS)历来是最常见的病因,因此,研究和指南主要聚焦于此。近期数据表明,在需要重症监护的患者群体中,非缺血性CS的负担正在增加。然而,对于这些分为两大类的患者的管理,即已有心力衰竭和CS的患者以及无已知心力衰竭病史而出现“CS”的患者,数据和指南都很匮乏。尽管临时机械循环支持(MCS)成本高昂、资源消耗大、并发症发生率高且缺乏高质量的结局数据,但它在所有病因中的应用都有所扩大。在此,我们讨论目前关于MCS在CS患者管理中的作用的现有证据,这些患者包括暴发性心肌炎、右心室(RV)衰竭、Takotsubo综合征、围产期心肌病以及瓣膜病变和其他心肌病导致的CS。

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本文引用的文献

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