PMID- 37116757
OWN - NLM
STAT- MEDLINE
DCOM- 20230609
LR  - 20230626
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 384
DP  - 2023 Aug 1
TI  - Echocardiographic findings in cardiogenic shock due to acute myocardial 
      infarction versus heart failure.
PG  - 38-47
LID - S0167-5273(23)00595-8 [pii]
LID - 10.1016/j.ijcard.2023.04.041 [doi]
AB  - BACKGROUND: Acute myocardial infarction (AMI) is the prototypical cause of 
      cardiogenic shock (CS), yet CS due to heart failure (HF-CS) is increasingly 
      common. Little is known regarding cardiac function in AMI-CS versus HF-CS. We 
      compared transthoracic echocardiography (TTE) findings in AMI-CS versus HF-CS and 
      identified predictors of mortality in AMI-CS patients. METHODS: We performed a 
      single-center, retrospective analysis of CS admissions between 2007 and 2018. We 
      compared baseline demographic and TTE parameters in patients with AMI-CS and 
      HF-CS as well as ST elevation myocardial infarction (STEMI)-CS versus non-ST 
      elevation myocardial infarction (NSTEMI)-CS. RESULTS: We included 893 unique 
      patients, including 581 (65%) with AMI-CS. AMI-CS patients were older but had 
      lower illness severity and non-cardiac comorbidity burden. AMI-CS patients had 
      better left ventricular function (LVEF 35% versus 28%), lower biventricular 
      filling pressures, and higher stroke volume versus those with HF-CS. Among TTE 
      measurements, myocardial contraction fraction had the highest discrimination for 
      mortality in AMI-CS (AUC: 0.64); AUC values for LVEF and SOFA score were 0.61 and 
      0.65, respectively. Differences in TTE findings between STEMI-CS versus NSTEMI-CS 
      were modest. There were no significant differences in unadjusted or adjusted 
      in-hospital mortality between AMI-CS and HF-CS (31% versus 35%) or STEMI-CS and 
      NSTEMI-CS (31% versus 30%) groups (all p > 0.05). CONCLUSIONS: Patients with 
      HF-CS and AMI-CS differ in terms of clinical and TTE variables yet have similar 
      prognoses. TTE is useful in determining prognosis of patients admitted with 
      AMI-CS and may allow for early triage and directed therapy.
CI  - Copyright (c) 2023 Elsevier B.V. All rights reserved.
FAU - Singam, Narayana Sarma V
AU  - Singam NSV
AD  - Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, 
      United States of America; Department of Critical Care Medicine, Washington 
      Hospital Center, Washington, DC, United States of America; Division of 
      Cardiology, Washington Hospital Center, Washington, DC, United States of America. 
      Electronic address: singamnv@gmail.com.
FAU - Tabi, Meir
AU  - Tabi M
AD  - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States 
      of America.
FAU - Wiley, Brandon
AU  - Wiley B
AD  - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States 
      of America.
FAU - Anavekar, Nandan
AU  - Anavekar N
AD  - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States 
      of America.
FAU - Jentzer, Jacob
AU  - Jentzer J
AD  - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States 
      of America.
LA  - eng
PT  - Journal Article
DEP - 20230426
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
SB  - IM
MH  - Humans
MH  - Shock, Cardiogenic/diagnostic imaging/etiology
MH  - *ST Elevation Myocardial Infarction/complications/diagnostic imaging
MH  - *Non-ST Elevated Myocardial Infarction/therapy
MH  - Retrospective Studies
MH  - *Myocardial Infarction/complications/diagnostic imaging
MH  - *Heart Failure/complications
MH  - Echocardiography
MH  - Hospital Mortality
OTO - NOTNLM
OT  - Cardiogenic shock
OT  - Heart failure
OT  - Mortality
OT  - Myocardial infarction
OT  - Transthoracic echocardiography
COIS- Declaration of Competing Interest Narayana Sarma V. Singam is a co-founder and 
      owner of High Enroll, LLC. None of the authors report a direct conflict of 
      interest for this work.
EDAT- 2023/04/29 06:04
MHDA- 2023/06/09 06:42
CRDT- 2023/04/28 19:28
PHST- 2022/12/30 00:00 [received]
PHST- 2023/03/11 00:00 [revised]
PHST- 2023/04/23 00:00 [accepted]
PHST- 2023/06/09 06:42 [medline]
PHST- 2023/04/29 06:04 [pubmed]
PHST- 2023/04/28 19:28 [entrez]
AID - S0167-5273(23)00595-8 [pii]
AID - 10.1016/j.ijcard.2023.04.041 [doi]
PST - ppublish
SO  - Int J Cardiol. 2023 Aug 1;384:38-47. doi: 10.1016/j.ijcard.2023.04.041. Epub 2023 
      Apr 26.