University of Chicago, Department of Medicine, Section of Cardiology, Chicago, Illinois.
Medical University of South Carolina, Department of Medicine, Section of Heart Failure, Charleston, South Carolina.
J Card Fail. 2023 Nov;29(11):1543-1555. doi: 10.1016/j.cardfail.2023.08.009. Epub 2023 Aug 24.
The accurate assessment of hemodynamics is paramount to providing timely and efficacious care for patients presenting in cardiogenic shock. Recently, the regular use of the pulmonary artery catheter in cardiogenic shock has had a resurgence with emerging data indicating improved survival in the modern era. Optimal multidisciplinary management of advanced heart failure and cardiogenic shock relies on our ability to effectively communicate and understand the complete hemodynamic assessment. Standardization of data acquisition and a renewed focus on the physiological processes, and thresholds driving disease progression, including the coupling ratio and myocardial reserve, are needed to fully understand and interpret the hemodynamic assessment. This State-of-the-Art review discusses best practices in the cardiac catheterization laboratory as well as emerging data on the prognostic role of emerging advanced hemodynamic parameters.
准确评估血流动力学对于为心源性休克患者提供及时有效的治疗至关重要。最近,肺动脉导管在心源性休克中的常规使用再次兴起,新出现的数据表明,在现代,这种方法可以提高生存率。先进心力衰竭和心源性休克的最佳多学科管理依赖于我们有效沟通和理解完整血流动力学评估的能力。需要对数据采集进行标准化,并重新关注推动疾病进展的生理过程和阈值,包括耦联比和心肌储备,以充分理解和解释血流动力学评估。本综述讨论了心导管实验室中的最佳实践,以及新兴先进血流动力学参数的预后作用的新兴数据。