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Updated: Aug 6, 2026
06:10
Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
Cardiac mechanical efficiency in patients with cardiogenic shock
Kristoffer Berg-Hansen1,2, Oskar Kjærgaard Hørsdal1,2, Henrik Wiggers1,2
1Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
European Heart Journal. Acute Cardiovascular Care
|July 22, 2026
Summary
Modified cardiac efficiency (mCE) measured by echocardiography predicts mortality in cardiogenic shock (CS). Lower mCE indicates higher risk, especially in acute coronary syndrome-related CS, aiding early risk stratification.
Area of Science:
- Cardiology
- Echocardiography
- Critical Care Medicine
Background:
- Cardiogenic shock (CS) involves impaired left ventricular (LV) function and remodeling.
- Early identification of high-risk CS patients is crucial for timely intervention.
Purpose of the Study:
- To assess if transthoracic echocardiography (TTE)-derived modified cardiac efficiency (mCE) predicts short- and long-term mortality in CS patients.
- To determine if the prognostic value of mCE varies by CS etiology.
Main Methods:
- Retrospective cohort study of 667 CS patients at Mayo Clinic (2007-2018).
- mCE calculated using stroke volume, LV end-systolic pressure, and LV end-systolic volume from TTE within 24 hours of admission.
- Outcomes: in-hospital and 1-year mortality, analyzed using multivariable models.
Main Results:
- Lower mCE quartiles were associated with increased in-hospital and 1-year mortality.
- The lowest mCE quartile showed a 2.5-fold higher adjusted odds of in-hospital death and a twofold higher adjusted hazard of 1-year death.
- Prognostic associations were stronger in acute coronary syndrome-related CS.
Conclusions:
- Early TTE-derived mCE is an independent predictor of mortality in CS.
- mCE effectively captures the interplay between ventricular remodeling and mechanical performance in high-risk CS phenotypes.
- mCE offers valuable prognostic information, particularly in ACS-related CS.
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