08.08.2024A paradigm shift in cardiogenic shock

Cardiogenic shock results from a self-reinforcing cycle of ventricular dysfunction, impaired organ perfusion, and systemic inflammation leading to derangements in the entire circulatory system and high short-term mortaliy rates of up to 50%.

In a View Point article, published in the European Heart Journal, Prof. Thomas F. Lüscher and Prof. Holger Thiele delineate why it is time for a paradigm shift in the treatment of this complex clinical syndrome. Early and timely inhibition of specific pathways fostering the downhill spiral during evolving shock, such as for instance the NLRP3–interleukin
and complement pathway as well as of circulating dipeptidyl peptidase 3 either alone or in combination, with left ventricular unloading in selected patients (‘hemo-metabolic unloading’) might be the future.

Florian Wenzl