Early Evaluation of Patients on Axial Flow Pump Support for Refractory Cardiogenic Shock Is Associated with Left Ventricular Recovery - Université Toulouse III - Paul Sabatier - Toulouse INP Accéder directement au contenu
Article Dans Une Revue Journal of Clinical Medicine Année : 2020

Early Evaluation of Patients on Axial Flow Pump Support for Refractory Cardiogenic Shock Is Associated with Left Ventricular Recovery

Frédéric Bouisset
Clément Delmas

Résumé

We investigated prognostic factors associated with refractory left ventricle (LV) failure leading to LV assist device (LVAD), heart transplant or death in patients on an axial flow pump support for cardiogenic shock (CS). Sixty-two CS patients with an Impella® CP or 5.0 implant were retrospectively enrolled, and clinical, biological, echocardiographic, coronarographic and management data were collected. They were compared according to the 30-day outcome. Patients were mainly male (n = 55, 89%), 58 ± 11 years old and most had no history of heart failure or coronary artery disease (70%). The main etiology of CS was acute coronary syndrome (n = 57, 92%). They presented with severe LV failure (LV ejection fraction (LVEF) 22 ± 9%), organ malperfusion (lactate 3.1 ± 2.1 mmol/L), and frequent use of inotropes, vasopressors, and mechanical ventilation (59, 66 and 30%, respectively). At 24 h, non-recovery was associated with higher total bilirubin (odds ratios (OR) 1.07 (1.00–1.14); p = 0.039), lower LVEF (OR 0.89 (0.81–0.96); p = 0.006) and the number of administrated amines (OR 4.31 (1.30–14.30); p = 0.016). Early evaluation in patients with CS with an axial flow pump implant may enable the identification of factors associated with an unlikely recovery and would call for early screening for LVAD or heart transplant.
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hal-04383539 , version 1 (09-01-2024)

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Jérôme Fagot, Frédéric Bouisset, Laurent Bonello, Caroline Biendel, Thibaut Lhermusier, et al.. Early Evaluation of Patients on Axial Flow Pump Support for Refractory Cardiogenic Shock Is Associated with Left Ventricular Recovery. Journal of Clinical Medicine, 2020, 9 (12), pp.4130. ⟨10.3390/jcm9124130⟩. ⟨hal-04383539⟩
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