Francesco Castagna MD, MSc , Mandeep R. Mehra MD, MSc , Christoph G.S. Nabzdyk MD , Michael M. Givertz MD
{"title":"心脏手术后血管截瘫综合征","authors":"Francesco Castagna MD, MSc , Mandeep R. Mehra MD, MSc , Christoph G.S. Nabzdyk MD , Michael M. Givertz MD","doi":"10.1016/j.jchf.2025.02.028","DOIUrl":null,"url":null,"abstract":"<div><div>Vasoplegia syndrome is a specific form of vasodilatory shock encountered in patients who undergo cardiac surgery, most commonly with cardiopulmonary bypass, which is characterized by severe hypotension in the presence of normal or increased cardiac output with abnormal tissue perfusion. Although numerous risk factors have been identified, the pathophysiology remains incompletely understood, and the therapeutic strategies are limited with a consequent poor prognosis. Current research on mechanisms and treatment has focused on targeting disequilibrium in the biological mediators of vasodilation and vasoconstriction that leads to profound hypotension and end-organ malperfusion. The morbidity and mortality rates are high, making vasoplegia syndrome a clinical area of unmet need. Looking ahead, use of standardized definitions and reporting of prospective outcomes as well as investigations into new mechanisms will be critical to identifying novel therapeutic targets and reducing the burden of vasoplegia syndrome.</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 7","pages":"Article 102482"},"PeriodicalIF":10.3000,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Vasoplegia Syndrome After Cardiac Surgery\",\"authors\":\"Francesco Castagna MD, MSc , Mandeep R. Mehra MD, MSc , Christoph G.S. Nabzdyk MD , Michael M. Givertz MD\",\"doi\":\"10.1016/j.jchf.2025.02.028\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><div>Vasoplegia syndrome is a specific form of vasodilatory shock encountered in patients who undergo cardiac surgery, most commonly with cardiopulmonary bypass, which is characterized by severe hypotension in the presence of normal or increased cardiac output with abnormal tissue perfusion. Although numerous risk factors have been identified, the pathophysiology remains incompletely understood, and the therapeutic strategies are limited with a consequent poor prognosis. Current research on mechanisms and treatment has focused on targeting disequilibrium in the biological mediators of vasodilation and vasoconstriction that leads to profound hypotension and end-organ malperfusion. The morbidity and mortality rates are high, making vasoplegia syndrome a clinical area of unmet need. Looking ahead, use of standardized definitions and reporting of prospective outcomes as well as investigations into new mechanisms will be critical to identifying novel therapeutic targets and reducing the burden of vasoplegia syndrome.</div></div>\",\"PeriodicalId\":14687,\"journal\":{\"name\":\"JACC. Heart failure\",\"volume\":\"13 7\",\"pages\":\"Article 102482\"},\"PeriodicalIF\":10.3000,\"publicationDate\":\"2025-06-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JACC. Heart failure\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2213177925004032\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JACC. Heart failure","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2213177925004032","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Vasoplegia syndrome is a specific form of vasodilatory shock encountered in patients who undergo cardiac surgery, most commonly with cardiopulmonary bypass, which is characterized by severe hypotension in the presence of normal or increased cardiac output with abnormal tissue perfusion. Although numerous risk factors have been identified, the pathophysiology remains incompletely understood, and the therapeutic strategies are limited with a consequent poor prognosis. Current research on mechanisms and treatment has focused on targeting disequilibrium in the biological mediators of vasodilation and vasoconstriction that leads to profound hypotension and end-organ malperfusion. The morbidity and mortality rates are high, making vasoplegia syndrome a clinical area of unmet need. Looking ahead, use of standardized definitions and reporting of prospective outcomes as well as investigations into new mechanisms will be critical to identifying novel therapeutic targets and reducing the burden of vasoplegia syndrome.
期刊介绍:
JACC: Heart Failure publishes crucial findings on the pathophysiology, diagnosis, treatment, and care of heart failure patients. The goal is to enhance understanding through timely scientific communication on disease, clinical trials, outcomes, and therapeutic advances. The Journal fosters interdisciplinary connections with neuroscience, pulmonary medicine, nephrology, electrophysiology, and surgery related to heart failure. It also covers articles on pharmacogenetics, biomarkers, and metabolomics.