Canadian Journal of Cardiology最新文献

{"title":"Differences in Care and Outcomes in Cardiogenic Shock in Cardiac Intensive Care Units in the United States and Canada: CCCTN Registry Insights","authors":"Madeleine Barker MD MPH ,&nbsp;Sean van Diepen MD, MSc ,&nbsp;Christopher B. Granger MD ,&nbsp;Graham C. Wong MD, MPH ,&nbsp;Vivian M. Baird-Zars MPH ,&nbsp;Jeong-Gun Park PhD ,&nbsp;Michael J. Goldfarb MD, MSc ,&nbsp;Patrick Lawler MD ,&nbsp;Adriana Luk MD ,&nbsp;ShuangBo Liu MD ,&nbsp;Brian J. Potter MD ,&nbsp;Michael A. Solomon MD, MBA ,&nbsp;Sammy Zakaria MD, MPH ,&nbsp;David A. Morrow MD, MPH ,&nbsp;Christopher B. Fordyce MD, MHS, MSc","doi":"10.1016/j.cjca.2025.01.012","DOIUrl":"10.1016/j.cjca.2025.01.012","url":null,"abstract":"<div><h3>Background</h3><div>Mortality in cardiogenic shock (CS) remains high. Significant interhospital heterogeneity in critical care therapies has been described, which reflects the lack of high-quality evidence to guide optimal treatment. We aimed to describe differences in practices and clinical outcomes among patients with CS in the United States and Canada.</div></div><div><h3>Methods</h3><div>The Critical Care Cardiology Trials Network (CCCTN) is a research network of tertiary cardiac intensive care units (CICUs). Data collection spanned from 2017 to 2022. The analysis included 34 American and 8 Canadian sites. The outcomes of interest included baseline clinical differences, use of critical care monitoring and therapies, and all-cause in-hospital mortality between patients with CS in the United States and Canada admitted to CICUs.</div></div><div><h3>Results</h3><div>Among 23,299 admissions, 19% had CS (n = 4336, 88% United States vs 12% Canada). The proportion of patient who received invasive hemodynamics (United States: 80.8% vs Canada: 74.8%, <em>P</em> = 0.0015), vasoactive medications (United States: 88.9% vs Canada: 82.1%, <em>P</em> &lt; 0.0001), temporary mechanical circulatory support (tMCS) (United States: 39.4% vs Canada: 23.1%, <em>P</em> &lt; 0.0001) were more frequent in US centres. Intra-aortic balloon pump was the most common tMCS device in both countries. After multivariable adjustment, in-hospital mortality was higher in Canada vs United States (37.1% vs 29.4%, odds ratio [OR]: 1.47; 95% confidence interval [CI], 1.18-1.83).</div></div><div><h3>Conclusions</h3><div>In a contemporary registry, management of CS was heterogenous between the United States and Canada, with higher use of invasive monitoring and MCS in the US. Although adjusted mortality was lower in the United States, the effects of these treatments cannot be reliably determined without randomized trial data.</div></div>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 4","pages":"Pages 718-727"},"PeriodicalIF":5.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Commentary to When Shock Hits the Border: Comparing US and Canadian Management of Cardiogenic Shock","authors":"Jean Deschamps MD ,&nbsp;Rakesh C. Arora MD, PhD","doi":"10.1016/j.cjca.2025.01.028","DOIUrl":"10.1016/j.cjca.2025.01.028","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 4","pages":"Pages 728-729"},"PeriodicalIF":5.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracorporeal Membrane Oxygenation in Pediatric Patients With Congenital Heart Disease: Surgical Considerations","authors":"Rachel D. Vanderlaan MD, PhD,&nbsp;David J. Barron MD","doi":"10.1016/j.cjca.2024.12.035","DOIUrl":"10.1016/j.cjca.2024.12.035","url":null,"abstract":"<div><div>The use of extracorporeal membrane oxygenation (ECMO) in the paediatric population has increased over time, with the ability to rescue pulmonary and cardiovascular deterioration. ECMO can be utilised by neonates and children with congenital heart disease in both preoperative and postoperative settings to improve survival and minimise morbidity. ECMO cannulation strategy must be tailored to the age, weight, and physiologic state of the patient. Careful patient selection and rapid deployment of ECMO may improve survival and morbidity in patients with congenital heart disease.</div></div>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 4","pages":"Pages 613-620"},"PeriodicalIF":5.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142963839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Five Years of the One Heart Team – A Milestone Worth Celebrating","authors":"","doi":"10.1016/j.cjca.2025.02.030","DOIUrl":"10.1016/j.cjca.2025.02.030","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 4","pages":"Pages 561-562"},"PeriodicalIF":5.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143807687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Echocardiography in Monitoring Patients Supported With Extracorporeal Membrane Oxygenation","authors":"E. Caroline Bullen MBBS, BSc ,&nbsp;Filio Billia MD, PhD ,&nbsp;Ghislaine Douflé MD, MME","doi":"10.1016/j.cjca.2024.10.024","DOIUrl":"10.1016/j.cjca.2024.10.024","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 4","pages":"Pages 775-778"},"PeriodicalIF":5.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated With Shock at Presentation in Kawasaki Disease Versus Multisystem Inflammatory Syndrome in Children Associated With Covid-19","authors":"Supriya S. Jain MD ,&nbsp;Ashraf S. Harahsheh MD ,&nbsp;Simon Lee MD ,&nbsp;Geetha Raghuveer MD ,&nbsp;Nagib Dahdah MD, MBA ,&nbsp;Michael Khoury MD ,&nbsp;Michael A. Portman MD ,&nbsp;Melissa Wehrmann MD ,&nbsp;Arash A. Sabati MD ,&nbsp;Marianna Fabi MD, PhD ,&nbsp;Deepika Thacker MD ,&nbsp;Nilanjana Misra MBBS ,&nbsp;Mark D. Hicar MD, PhD ,&nbsp;Nadine F. Choueiter MD ,&nbsp;Matthew D. Elias MD ,&nbsp;Audrey Dionne MD ,&nbsp;William B. Orr MD ,&nbsp;Jacqueline R. Szmuszkovicz MD ,&nbsp;Seda Selamet Tierney MD ,&nbsp;Luis Martin Garrido-Garcia MD, MSc ,&nbsp;Varsha Zadokar MBBS","doi":"10.1016/j.cjca.2024.11.027","DOIUrl":"10.1016/j.cjca.2024.11.027","url":null,"abstract":"<div><h3>Background</h3><div>While clinical overlap between Kawasaki disease (KD) and multisystem inflammatory syndrome in children (MIS-C) has been evident, information regarding those presenting with shock has been limited. We sought to determine associations with shock within and between diagnosis groups.</div></div><div><h3>Methods</h3><div>The International KD Registry enrolled contemporaneous patients with either KD or MIS-C from 39 sites in 7 countries from January 1, 2020, to January 1, 2023. Demographics, clinical features and presentation, management, laboratory values, and outcomes were compared between the diagnosis and shock groups.</div></div><div><h3>Results</h3><div>Shock at presentation was noted for 19 of 672 KD patients (2.8%) and 653 of 1472 MIS-C patients (44%; <em>P</em> &lt; 0.001). Within both groups, patients with shock were significantly more likely to be admitted to the intensive care unit, to receive inotropes, and to have greater laboratory abnormalities indicative of hyperinflammation and organ dysfunction, including abnormal cardiac biomarkers. Patients with KD and shock had a greater maximum coronary artery <em>z</em> score (median +2.62) vs KD patients without shock (+1.36; <em>P</em> &lt; 0.001) and MIS-C patients with shock (+1.45 [vs +1.32 for MIS-C patients without shock]; <em>P</em> &lt; 0.001). They were also more likely to have large coronary artery aneurysms. In contrast, MIS-C patients with shock had lower left ventricular ejection fraction (mean 51.6%) vs MIS-C patients without shock (56.6%; <em>P</em> &lt; 0.001) and KD patients with shock (56.7% [vs 62.8% for KD patients without shock]; <em>P</em> = 0.04).</div></div><div><h3>Conclusions</h3><div>Although patients with KD presenting with shock are clinically similar to patients with MIS-C, especially those with shock, they have more severe coronary artery involvement, whereas MIS-C patients with shock have lower left ventricular ejection fraction.</div></div>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 4","pages":"Pages 740-748"},"PeriodicalIF":5.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Double Sequential External Defibrillation for Refractory Ventricular Fibrillation: A Perspective on the Canadian Cardiovascular Society Practice Update","authors":"Sheldon Cheskes MD,&nbsp;Paul Dorian MD, MSc,&nbsp;Ian R. Drennan ACP, PhD,&nbsp;Damon C. Scales MD, PhD","doi":"10.1016/j.cjca.2024.05.011","DOIUrl":"10.1016/j.cjca.2024.05.011","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 4","pages":"Page 792"},"PeriodicalIF":5.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141330434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Life-Saving Combination of Extracorporeal Membrane Oxygenation, Percutaneous Aspiration, and Valvuloplasty in a Pulmonary Prosthetic Valve Endocarditis","authors":"Daniel Tébar Márquez MD ,&nbsp;Santiago Jiménez-Valero MD ,&nbsp;Alfonso Jurado-Román MD, PhD ,&nbsp;Guillermo Galeote MD, PhD ,&nbsp;Pablo Meras-Colunga MD ,&nbsp;Ángel Aroca MD, PhD ,&nbsp;Fernando Leyra MD, PhD ,&nbsp;Isabel Higuera MD ,&nbsp;José Ruíz Cantador MD ,&nbsp;Raúl Moreno MD, PhD","doi":"10.1016/j.cjca.2024.08.267","DOIUrl":"10.1016/j.cjca.2024.08.267","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 4","pages":"Pages 761-763"},"PeriodicalIF":5.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overcoming Inertia in Cardiogenic Shock: Bridging Gaps and Advancing Care","authors":"Christopher B. Fordyce MD, MHS, MSc, FRCPC ,&nbsp;Filio Bilia MD, PhD, FRCPC ,&nbsp;Warwick Butt MB, BS, FRACP, FJFICM ,&nbsp;Ren Jie Robert Yao MD ,&nbsp;Yoan Lamarche MD, MSc, FRCSC ,&nbsp;Varinder K. Randhawa MD, PhD, FRCPC ,&nbsp;Sean van Diepen MD, MSc, FRCPC","doi":"10.1016/j.cjca.2025.03.007","DOIUrl":"10.1016/j.cjca.2025.03.007","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 4","pages":"Pages 563-567"},"PeriodicalIF":5.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Comparative Epidemiology, Pathophysiology and Management of Cardiogenic Shock Associated With Acute Myocardial Infarction and Advanced Heart Failure","authors":"Varinder K. Randhawa MD, PhD ,&nbsp;David A. Baran MD ,&nbsp;Manreet K. Kanwar MD ,&nbsp;Jaime A. Hernandez-Montfort MD, MPH, MSc ,&nbsp;Shashank S. Sinha MD, MSc ,&nbsp;Christopher F. Barnett MD, MPH ,&nbsp;Filio Billia MD, PhD","doi":"10.1016/j.cjca.2025.01.027","DOIUrl":"10.1016/j.cjca.2025.01.027","url":null,"abstract":"<div><div>Cardiogenic shock (CS) results from low cardiac output caused by myocardial dysfunction, coupled with systemic end-organ tissue hypoperfusion and elevated ventricular filling pressures, along a spectrum of shock severity. This narrative review aims to compare the epidemiology, pathophysiology, and contemporary management of 2 common etiologies of CS caused by acute myocardial infarction (AMI-CS) and advanced heart failure (HF-CS). CS complicates up to 14% of AMI and 5% of HF admissions. Rapid therapeutic intervention after prompt recognition of CS etiology is the mainstay toward improving clinical outcomes and mitigating end-organ sequelae and death. In AMI-CS, persistent hypotension often leads to subsequent hypoperfusion and congestion, and early culprit coronary artery lesion revascularization is critical. In HF-CS, congestion often precedes hypoperfusion and hypotension, and targeting the underlying nonischemic cause of myocardial dysfunction is key. Tailoring of hemodynamic strategies with vasoactive agents and temporary mechanical circulatory and end-organ support to manage the predominant ventricular failure, hemometabolic phenotypes, and shock severity associated with each etiology is discussed. Given the limited evidence-base in CS care, we also highlight potential knowledge gaps ripe for future exploration.</div></div>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 4","pages":"Pages 573-586"},"PeriodicalIF":5.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}