Integrating Interventional Cardiology and Heart Failure Management for Cardiogenic Shock

Kapur, Navin K.; Davila, Carlos D.; Jumean, Marwan

doi:10.1016/j.iccl.2017.03.014

Cited by 13 publications

(26 citation statements)

References 21 publications

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“…In routine clinical practice, the choice of MCS device usually depends on its availability at the centre and on whether the left or right ventricle alone, or both, are compromised. Patients with primarily RV or biventricular failure are usually treated with an extracorporeal centrifugal flow-based regimen (V-A ECMO, iVAC, TandemHeart and ProtekDuo) 291 . Analyses of data from experienced centres show that the combination of a V-A ECMO with an IABP, an iVAC (EC-iVAC) or LV Impella (ECMELLA) is safe and probably more effective than a single V-A ECMO approach in patients with fulminant myocarditis 292,301,302 .…”

Section: Mechanical Circulatory Support In Patients With Fulminant Mymentioning

confidence: 99%

Myocarditis and inflammatory cardiomyopathy: current evidence and future directions

et al. 2020

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Inflammatory cardiomyopathy is defined as myocarditis in association with cardiac dysfunction and ventricular remodelling 1,2. Despite extensive research and improved diagnosis and understanding of the pathogenesis of inflammatory cardiomyopathy, this disorder is still associated with a poor prognosis when complicated by left ventricular (LV) dysfunction, heart failure (HF) or arrhythmia 3. Furthermore, fulminant myocarditis, a rare, sudden and severe cardiac inflammation, is one of the main causes of cardiogenic shock in young adults 4,5. Prompt diagnosis and specific treatment strategies are needed to reduce mortality and the need for heart transplantation in these patients 4,5. Many questions remain unanswered regarding the pathogenesis of inflammatory cardiomyopathy and the role of the viral infection, the immune system, the host genetic background and the environment in disease progression and prognosis. These gaps in knowledge highlight the need for advanced experimental systems that can better model the human immune system and the need to improve the characterization and classification of the patients, for example, with the use of phenomapping and phenomics, which involve detailed evaluation of immune status, viral presence and/or other biomarkers. In this Review, we discuss the available evidence and identify the gaps in our understanding of the pathogenesis, diagnosis, treatment and prognosis of myocarditis and inflammatory cardiomyopathy, appraise the available animal and cell models of these conditions and propose future directions for the field. We discuss the role

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Section: Mechanical Circulatory Support In Patients With Fulminant Mymentioning

confidence: 99%

Myocarditis and inflammatory cardiomyopathy: current evidence and future directions

et al. 2020

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“…A 2004 manuscript by Adamson and colleagues has proposed a formal training program wherein HF trainees would gain proficiency in the cognitive and technical aspects of device implantation, and now serves as a guiding principle for these budding dual-fellowship options [17]. Recently, growing interest and clinical demand have led to the development of interventional HF programs, whereby interventional cardiologists fulfill training requirements for advanced HF, thereby allowing them to think like an HF specialist, while operating like interventional cardiologists [18][19][20].…”

Section: Educating the Workforcementioning

confidence: 99%

A manifesto of collaborative longitudinal cardiovascular care in heart failure

et al. 2020

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In this document, we outline the challenges faced by patients and clinicians in heart failure, specifically centered around the needed coordination of care among the various subspecialties within cardiovascular medicine. We call for a more organized and collaborative effort among clinicians in primary care, general cardiology, electrophysiology, interventional cardiology, cardiothoracic surgery, cardiac imaging, and heart failure-all caring for mutual patients. Care is contextualized within the framework of two phases: a cardiomyopathy phase and an advanced heart failure phase, each of which lends to different considerations in therapy. Ultimately multidisciplinary coordinated care within cardiovascular medicine may lead to greater patient and clinician satisfaction as well as improved outcomes, but this remains to be investigated.

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“…It needs to be underlined that reperfusion in CS remains the same important therapeutic step, even if a little delayed by the early insertion of MS. 20 has been proved to be directly associated with survival, the timely initiation of adequate measures to restore the severely altered myocardial performance in CS can be lifesaving. [24][25][26] For this purpose, new devices have been developed with the aim of providing increased mechanical circulatory support and improved survival in case of refractory CS.…”

Section: Reperfusion In Csmentioning

confidence: 99%

A Long-Forgotten Tale: The Management of Cardiogenic Shock in Acute Myocardial Infarction

Iancu

Dregoesc

Solomoneanu

et al. 2018

Journal of Cardiovascular Emergencies

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Patients with acute myocardial infarction (AMI) complicated with cardiogenic shock (CS) present one of the highest mortality rates recorded in critical care. Mortality rate in this setting is reported around 45-50% even in the most experienced and well-equipped medical centers. The continuous development of ST-segment elevation acute myocardial infarction (STEMI) networks has led not only to a dramatic decrease in STEMI-related mortality, but also to an increase in the frequency of severely complicated cases who survive to be transferred to tertiary centers for life-saving treatments. The reduced effectiveness of vasoactive drugs on a severely altered hemodynamic status led to the development of new devices dedicated to advanced cardiac support. What’s more, efforts are being made to reduce time from first medical contact to initiation of mechanical support in this particular clinical context. This review aims to summarize the most recent advances in mechanical support devices, in the setting of CS-complicated AMI. At the same time, the review presents several modern concepts in the organization of complex CS centers. These specialized hubs could improve survival in this critical condition.

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Integrating Interventional Cardiology and Heart Failure Management for Cardiogenic Shock

Cited by 13 publications

References 21 publications

Myocarditis and inflammatory cardiomyopathy: current evidence and future directions

Myocarditis and inflammatory cardiomyopathy: current evidence and future directions

A manifesto of collaborative longitudinal cardiovascular care in heart failure

A Long-Forgotten Tale: The Management of Cardiogenic Shock in Acute Myocardial Infarction

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