RIGHT VENTRICULAR DYSFUNCTION AS A MORTALITY DETERMINANT FOR PATIENTS WITH CARDIOGENIC SHOCK INDUCED BY ACUTE...

Area of Science:

• Cardiology
• Critical Care Medicine
• Echocardiography

Background:

• Cardiogenic shock (CS) following acute myocardial infarction (AMI) is a leading cause of in-hospital death.
• The presence of right ventricular dysfunction (RVD) exacerbates poor outcomes in CS-AMI patients.
• Early detection and management of RVD are critical for improving patient survival.

Purpose of the Study:

• To investigate the impact of RVD on in-hospital and long-term mortality in patients experiencing CS secondary to AMI.
• To identify predictors of mortality in CS-AMI patients with and without RVD.
• To emphasize the importance of RVD assessment and tailored management strategies.

Main Methods:

• Analysis of data from the Gulf Cardiogenic Shock (Gulf-CS) registry, a multicenter registry of CS-AMI patients.
• Comparison of in-hospital and long-term outcomes between patients with and without RVD, defined by echocardiographic criteria.
• Utilized multivariable logistic and Cox regression models to identify mortality predictors.

Main Results:

• RVD was independently associated with significantly higher in-hospital mortality (55.87% vs. 42.89%, P < 0.001).
• Patients with RVD exhibited lower long-term survival rates at 6, 12, 18, and 24 months compared to those without RVD (P < 0.001).
• Identified key predictors for in-hospital and follow-up mortality, including shock stage, cardiac arrest, age, comorbidities, and cardiac function parameters.

Conclusions:

• Right ventricular dysfunction is a significant independent predictor of both short-term and long-term mortality in CS-AMI.
• Early echocardiographic assessment for RVD is essential in CS-AMI patients.
• Integrating RV-focused management strategies is recommended to enhance survival outcomes in this vulnerable patient population.