Publications by authors named "Jonas Sundermeyer"
Aims: Mortality for cardiogenic shock (CS) remains high. To improve outcomes, centralization of treatment in specialized centres, especially those with expertise in mechanical circulatory support (MCS), has been recommended. High-volume centres may be able to provide standardized, better care.
View Article and Find Full Text PDFAims: Heart failure-related cardiogenic shock (HF-CS) accounts for about half of CS cases, with a paucity of data regarding the role of kidney injury in this subset. This study aims to evaluate patient characteristics and outcome associated with renal function in patients with HF-CS.
Methods And Results: In this multicentre, international, retrospective study, patients with HF-CS from 16 tertiary care centres in five countries were enrolled between 2010 and 2021.
Aims: This study aimed to investigate incidence and predictors of weaning failure and in-hospital death after successful weaning from veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in patients with cardiogenic shock (CS).
Methods And Results: Overall, 685 patients with CS treated with VA-ECMO from 23 tertiary care centres in 7 countries were analysed (median age 57 [interquartile range 49-66] years, 542 [79.1%] male, median lactate 7.
Aims: The optimal timing for implementing mechanical circulatory support (MCS) in cardiogenic shock (CS) remains indeterminate. This study aims to evaluate patient characteristics and outcome associated with the time interval between CS onset and veno-arterial extracorporeal membrane oxygenation (VA-ECMO) implementation.
Methods And Results: In this study, patients with CS treated with MCS at 15 tertiary care centres in three countries were enrolled.
Pro-adrenomedullin associates with congestion in acute heart failure patients.
ESC Heart Fail
December 2024
Article Synopsis
- Congestion significantly impacts outcomes in acute heart failure, and assessing it can be complicated, making effective treatment difficult; residual congestion at discharge increases risks of re-hospitalization and mortality.
- A study involving 233 patients with acute heart failure assessed the link between pro-adrenomedullin levels and congestion as well as clinical outcomes like in-hospital death and post-discharge mortality, revealing that higher pro-adrenomedullin levels are tied to worse outcomes.
- Findings suggest that monitoring pro-adrenomedullin can serve as a useful marker for evaluating congestion and guiding therapies in acute heart failure patients, with elevated levels correlating with heightened risk of worsening heart failure and death post-discharge.
Article Synopsis
- A study evaluated whether giving heparin before arriving at the hospital improves outcomes for patients with suspected non-ST segment elevation acute coronary syndrome (NSTE-ACS).
- The research included 1,234 patients from 2013 to 2021, comparing those who received pre-hospital heparin to those who did not, using statistical methods to analyze mortality rates after 30 days and one year.
- Results showed no significant difference in mortality rates between the groups and low rates of bleeding, suggesting that pre-hospital heparin may not be beneficial for this type of patient and should be used more cautiously.
Aims: Acute heart failure (AHF) can result in worsening of heart failure (WHF), cardiogenic shock (CS), or death. Risk factors for these adverse outcomes are not well characterized. This study aimed to identify predictors for WHF or new-onset CS in patients hospitalized for AHF.
View Article and Find Full Text PDFArticle Synopsis
- * Women with HF-CS tend to be older, have fewer prior heart issues, and lower rates of severe heart dysfunction compared to men, yet both genders received similar treatments.
- * Despite ranking equally in treatment use, the 30-day mortality rates were also comparable between sexes (around 53% for women and 51% for men), suggesting the need for further investigation into sex-specific treatment strategies.
Article Synopsis
- Researchers studied the use of mechanical circulatory support (MCS) in patients with non-ischaemic cardiogenic shock (CS), focusing on how left ventricular ejection fraction (LVEF) could influence patient outcomes.
- An analysis of 807 patients showed that while lower LVEF was linked to more severe shock, it didn't correlate with overall 30-day mortality risk; however, MCS appeared to reduce mortality in those with severely reduced LVEF (≤20%).
- The study suggests that incorporating LVEF into decision-making for MCS in non-ischaemic CS patients could improve patient outcomes by optimizing the benefit-risk ratio.
Article Synopsis
- Mortality rates in cardiogenic shock remain high, even with mechanical support, and this study explores the relationship between inflammation (measured by C-reactive protein or CRP) and patient outcomes.
- The analysis involved 1,116 patients with a median age of 70; higher CRP levels correlated with increased mortality risk, especially in those not treated with mechanical circulatory support.
- The findings suggest that while elevated CRP indicates worse outcomes in cardiogenic shock, mechanical circulatory support may mitigate this risk, indicating a complex interaction between inflammation and treatment effectiveness.
Article Synopsis
- - The study aimed to compare clinical characteristics and 30-day mortality rates between patients with de novo heart failure-related cardiogenic shock (HF-CS) and those with acute-on-chronic HF-CS, finding significant differences in outcomes.
- - An analysis of 1,030 patients revealed that while traditional markers of severity were similar, acute-on-chronic HF-CS was linked to higher mortality rates (55.9% vs. 45.5%) and greater severity of shock.
- - The results suggest that the chronicity of heart failure significantly influences the severity of cardiogenic shock, underlining the need to consider this factor in future clinical trials.
Article Synopsis
- VA-ECMO therapy helps patients with cardiogenic shock by restoring circulation but can lead to various complications affecting survival and neurological outcomes.
- A study analyzed data from 501 patients across 16 centers, revealing that over half experienced complications, especially women, with 40% mortality within 30 days.
- The findings indicate a need for better identification of patients at risk for complications to improve treatment strategies, as most adverse events correlate with worse prognosis.
Incidence of hypoxic hepatitis in patients with cardiogenic shock and association with mortality.
Eur Heart J Acute Cardiovasc Care
October 2023
Article Synopsis
- - The study examines the relationship between hypoxic hepatitis (S-HH) and cardiogenic shock (CS), finding that the traditional S-HH definition used for septic shock may not apply to CS patients, as it showed no significant association with in-hospital mortality.
- - Researchers analyzed data from 698 CS patients and found that a new definition for hypoxic hepatitis in CS (C-HH) indicated a ≥1.34-fold increase in ASAT and ≥1.51-fold increase in ALAT levels, with C-HH affecting 36% of patients and strongly correlating with higher mortality risk (odds ratio 2.36).
- - The findings suggest that C-HH is an important and common complication in
Aims: Despite its high incidence and mortality risk, there is no evidence-based treatment for non-ischaemic cardiogenic shock (CS). The aim of this study was to evaluate the use of mechanical circulatory support (MCS) for non-ischaemic CS treatment.
Methods And Results: In this multicentre, international, retrospective study, data from 890 patients with non-ischaemic CS, defined as CS due to severe de-novo or acute-on-chronic heart failure with no need for urgent revascularization, treated with or without active MCS, were collected.
Background: It is currently unclear if active left ventricular (LV) unloading should be used as a primary treatment strategy or as a bailout in patients with cardiogenic shock (CS) treated with venoarterial extracorporeal membrane oxygenation (VA-ECMO).
Objectives: This study sought to evaluate the association between timing of active LV unloading and implantation of VA-ECMO with outcomes of patients with CS.
Methods: Data from 421 patients with CS treated with VA-ECMO and active LV unloading at 18 tertiary care centers in 4 countries were analyzed.
Aims: Early risk stratification is essential to guide treatment in cardiogenic shock (CS). Existing CS risk scores were derived in selected cohorts, without accounting for the heterogeneity of CS. The aim of this study was to develop a universal risk score (the Cardiogenic Shock Score, CSS) for all CS patients, irrespective of the underlying cause.
View Article and Find Full Text PDFArticle Synopsis
- - The study evaluates how well the enrollment criteria of major randomized controlled trials (RCTs) for mechanical circulatory support devices apply to real-world patients experiencing cardiogenic shock (CS), revealing that only about 31.8% of these patients qualified for any trial.
- - It was found that the most restrictive eligibility came from the DanGer-SHOCK trial, with a primary reason for non-eligibility being the absence of CS caused by acute myocardial infarction; even among eligible patients, only 65.4% met the criteria when AMI was involved.
- - The results suggest these RCTs represent only a small segment of the CS population, emphasizing the need for more inclusive trials that account for patients who do
Article Synopsis
- * The study investigates the role of ULK1, an autophagic protein, showing that inhibiting ULK1 can reduce AAD in both lab cultures and live animal models.
- * The results suggest ULK1 contributes to axonal degeneration by affecting autophagy and mTOR activity, identifying it as a potential target for therapeutic interventions.