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Pulmonary vascular impedance in cardiogenic shock
||Pulmonary vascular impedance as a novel tool to understand right ventricular afterload in cardiogenic shock
Heart Failure, Shock
||Gaurav Gulati, MD
Cardiogenic shock (CS) is a dangerous clinical condition where the heart’s ability to pump blood is so compromised that it cannot support the vital functions of the rest of the body. CS has an increased risk of death of 50-60%, and despite tremendous research effort over the last decade, survival outcomes have not changed over this period. Current treatment for CS often involves mechanical circulatory support (MCS) devices, which are mechanical pumps that help support blood flow to the body. These devices primarily support left ventricular (LV) heart function (the function of the main chamber of your heart). However, many patients with CS have right ventricular (RV) dysfunction as well, which is difficult to manage and associated with shortened lifespan. Better recognition and management of right ventricular (RV) failure is therefore critical for improving clinical outcomes in CS. This research will use a new way to measure RV afterload, which is the force resisting the ejection of blood from the RV. We hope that by using this new method, we can better understand how to treat future patients with CS.
- Cardiogenic shock requiring mechanical circulatory support OR
- More than 6 months post-heart transplant
- Cardiac arrest within prior 12 hours
- Mechanical ventilation
Participants with cardiogenic shock will have 2 study assessments while in the hospital that consist of an echocardiogram, measurements from a pulmonary arterial catheter, and a blood draw of 1 tablespoon. Participants who have heart transplants will have 1 study assessment at the time of a regularly scheduled catheterization that consists of one echocardiogram.