{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T10:14:42Z","timestamp":1771409682898,"version":"3.50.1"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":357,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T00:00:00Z","timestamp":1740528000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Cardiogenic shock (CS) patients suffer from severe organ hypoperfusion, yet the incidence of secondary sclerosing cholangitis in critically ill patients (SSC-CIP) in CS is poorly described. Given the limited evidence and severity of this syndrome, we aimed to further investigate SSC-CIP in the context of CS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>24\u2009251 total CS patients admitted between 1 January 2010 and 31 December 2023 were retrospectively screened for the diagnosis of SSC-CIP across nine German tertiary care centers. Following identification of confirmed SSC-CIP diagnosis, baseline characteristics, laboratory values, SSC-CIP-specific imaging, diagnostics, and outcomes were obtained for analysis. 35 CS patients with a diagnosis of SSC-CIP were identified, representing a prevalence of 0.14% [95% confidence interval (CI) 0.10, 0.19]. Patients were predominantly male (77.1%) with a median age of 58 years (interquartile range [IQR] 52.5, 68.0). Acute myocardial infarction (42.9%) was the most common aetiology of CS, followed by cardiac arrhythmias (20.0%). Endoscopic retrograde cholangiopancreatography (ERCP) was performed in 77.1% of cases after a median of 33 days following CS onset [IQR 24, 65], showing typical biliary casts (60.0%), intraductal filling defects (28.6%), and bile duct obliteration (20.0%). Cast removal and stent placement was performed in nearly half of ERCP procedures (45.7%). Magnetic resonance cholangiopancreatography (MRCP) was performed in 22.9% of cases and showed intraductal dilation (11.4%), lumen narrowing (17.1%), or strictures (14.3%). Median intensive care unit and hospital length of stay was 43 days [IQR 33, 66] and 58 days [IQR 33, 88], respectively. In-hospital mortality was 57.1%. One-year (65.7%) and 3-year (71.4%) mortality remained high. Two patients underwent liver transplantation after a median of 113 days [IQR 105, 122] and were alive at 3-year follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this multicentre retrospective analysis in a high-risk CS cohort, SSC-CIP was a rare yet serious complication of intensive care unit stay with high in-hospital mortality. Treatment options are limited, and liver transplantation remains the only viable long-term treatment option.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.15248","type":"journal-article","created":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T16:48:53Z","timestamp":1740588533000},"page":"2239-2244","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Secondary Sclerosing Cholangitis in Patients Suffering Cardiogenic Shock"],"prefix":"10.1093","volume":"12","author":[{"given":"Hugo","family":"Lanz","sequence":"first","affiliation":[{"name":"Medizinische Klinik und Poliklinik I, Klinikum der Universit\u00e4t M\u00fcnchen, Munich, Germany and DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance , Munich ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clemens","family":"Scherer","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik I, Klinikum der Universit\u00e4t M\u00fcnchen, Munich, Germany and DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance , Munich ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp","family":"Kasper","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Gastroenterologie und Hepatologie, Universit\u00e4tsklinikum K\u00f6ln , K\u00f6ln ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Adler","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Kardiologie, Angiologie, Pneumologie und internistische Intensivmedizin, Klinik III f\u00fcr Innere Medizin, Herzzentrum, Universit\u00e4t zu K\u00f6ln , K\u00f6ln ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonhard","family":"Binzenh\u00f6fer","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik I, Klinikum der Universit\u00e4t M\u00fcnchen, Munich, Germany and DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance , Munich ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabine","family":"Hoffmann","sequence":"additional","affiliation":[{"name":"Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians, Universit\u00e4t M\u00fcnchen , Munich ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"H\u00f6pler","sequence":"additional","affiliation":[{"name":"Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians, Universit\u00e4t M\u00fcnchen , Munich ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie","family":"Kraft","sequence":"additional","affiliation":[{"name":"Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians, Universit\u00e4t M\u00fcnchen , Munich ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nils","family":"Gade","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik I, Klinikum der Universit\u00e4t M\u00fcnchen, Munich, Germany and DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance , Munich ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ra\u00fal Nicol\u00e1s","family":"Jamin","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik II, Universit\u00e4tsklinikum Bonn , Bonn ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruben","family":"Evertz","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Pneumology, University of G\u00f6ttingen Medical Center , G\u00f6ttingen ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Hoyer","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinik und Poliklinik f\u00fcr Innere Medizin III Kardiologie, Angiologie und Internistische Intensivmedizin, Universit\u00e4tsklinikum Halle (Saale) , Halle (Saale) ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00f6rn","family":"Tongers","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinik und Poliklinik f\u00fcr Innere Medizin III Kardiologie, Angiologie und Internistische Intensivmedizin, Universit\u00e4tsklinikum Halle (Saale) , Halle (Saale) ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Schulze","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Innere Medizin I, Universit\u00e4tsklinikum Jena , Jena ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Jung","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Hospital D\u00fcsseldorf, Heinrich-Heine-University D\u00fcsseldorf , D\u00fcsseldorf ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Claus","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine\/Cardiology, Leipzig Heart Institute, Heart Center Leipzig at University of Leipzig , Leipzig ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janine","family":"P\u00f6ss","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine\/Cardiology, Leipzig Heart Institute, Heart Center Leipzig at University of Leipzig , Leipzig ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Crusius","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Innere Medizin und Kardiologie, Herzzentrum-Dresden an der Technischen Universit\u00e4t Dresden , Dresden ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norman","family":"Mangner","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Innere Medizin und Kardiologie, Herzzentrum-Dresden an der Technischen Universit\u00e4t Dresden , Dresden ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Hagl","sequence":"additional","affiliation":[{"name":"Herzchirurgische Klinik und Poliklinik, Klinikum der Universit\u00e4t M\u00fcnchen , Munich ,","place":["Germany"]},{"name":"DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance , Munich ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georg","family":"Nickenig","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik II, Universit\u00e4tsklinikum Bonn , Bonn ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Zimmer","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik II, Universit\u00e4tsklinikum Bonn , Bonn ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steffen","family":"Massberg","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik I, Klinikum der Universit\u00e4t M\u00fcnchen, Munich, Germany and DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance , Munich ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Holger","family":"Thiele","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine\/Cardiology, Leipzig Heart Institute, Heart Center Leipzig at University of Leipzig , Leipzig ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franz","family":"Haertel","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Innere Medizin I, Universit\u00e4tsklinikum Jena , Jena ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3214-5672","authenticated-orcid":false,"given":"Enzo","family":"L\u00fcsebrink","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik II, Universit\u00e4tsklinikum Bonn , Bonn ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,2,26]]},"reference":[{"key":"2026021804273932500_ehf215248-bib-0001","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1007\/s00392-016-1060-3","article-title":"Incidence, laboratory detection and prognostic relevance of hypoxic hepatitis in cardiogenic shock","volume":"106","author":"Jung","year":"2017","journal-title":"Clin Res Cardiol"},{"key":"2026021804273932500_ehf215248-bib-0002","doi-asserted-by":"publisher","DOI":"10.1186\/2047-783X-17-30","article-title":"Abdominal obesity and prolonged prone positioning increase risk of developing sclerosing cholangitis in critically ill patients with influenza A-associated ARDS","volume":"17","author":"Weig","year":"2012","journal-title":"Eur J Med Res"},{"key":"2026021804273932500_ehf215248-bib-0003","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1016\/S1665-2681(19)30764-1","article-title":"Secondary sclerosing cholangitis following major burn","volume":"14","author":"Ben-Ari","year":"2015","journal-title":"Ann Hepatol"},{"key":"2026021804273932500_ehf215248-bib-0004","doi-asserted-by":"publisher","first-page":"1055","DOI":"10.1055\/s-0032-1325733","article-title":"Secondary sclerosing cholangitis in critically ill patients: model of end-stage liver disease score and renal function predict outcome","volume":"44","author":"Voigtl\u00e4nder","year":"2012","journal-title":"Endoscopy"},{"key":"2026021804273932500_ehf215248-bib-0005","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-015-0861-5","article-title":"Trigger mechanisms of secondary sclerosing cholangitis in critically ill patients","volume":"19","author":"Leonhardt","year":"2015","journal-title":"Crit Care"},{"key":"2026021804273932500_ehf215248-bib-0006","doi-asserted-by":"publisher","first-page":"1221","DOI":"10.1111\/j.1572-0241.2007.01118.x","article-title":"Ischemic-like cholangiopathy with secondary sclerosing cholangitis in critically ill patients","volume":"102","author":"Gelbmann","year":"2007","journal-title":"Am J Gastroenterol"},{"key":"2026021804273932500_ehf215248-bib-0007","doi-asserted-by":"publisher","first-page":"105","DOI":"10.2147\/CEG.S115518","article-title":"Secondary sclerosing cholangitis in critically ill patients: current perspectives","volume":"10","author":"Gudnason","year":"2017","journal-title":"Clin Exp Gastroenterol"},{"key":"2026021804273932500_ehf215248-bib-0008","doi-asserted-by":"publisher","first-page":"e232","DOI":"10.1161\/CIR.0000000000000525","article-title":"Contemporary management of cardiogenic shock: a scientific statement from the American Heart Association","volume":"136","author":"van Diepen","year":"2017","journal-title":"Circulation"},{"key":"2026021804273932500_ehf215248-bib-0009","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000002188","article-title":"Secondary sclerosing cholangitis in critically ill patients: clinical presentation, cholangiographic features, natural history, and outcome: a series of 16 cases","volume":"94","author":"Leonhardt","year":"2015","journal-title":"Medicine (Baltimore)"},{"key":"2026021804273932500_ehf215248-bib-0010","doi-asserted-by":"publisher","first-page":"1295","DOI":"10.1002\/lt.24192","article-title":"Liver transplantation for critically ill patients with secondary sclerosing cholangitis: outcome and complications","volume":"21","author":"Voigtl\u00e4nder","year":"2015","journal-title":"Liver Transpl"},{"key":"2026021804273932500_ehf215248-bib-0011","doi-asserted-by":"publisher","first-page":"1090","DOI":"10.1016\/j.amjcard.2017.06.049","article-title":"Frequency and prognostic significance of abnormal liver function tests in patients with cardiogenic shock","volume":"120","author":"J\u00e4ntti","year":"2017","journal-title":"Am J Cardiol"},{"key":"2026021804273932500_ehf215248-bib-0012","doi-asserted-by":"publisher","first-page":"730","DOI":"10.1055\/s-2006-925241","article-title":"Secondary sclerosing cholangitis after long-term treatment in an intensive care unit: clinical presentation, endoscopic findings, treatment, and follow-up","volume":"38","author":"Jaeger","year":"2006","journal-title":"Endoscopy"}],"container-title":["ESC Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/12\/3\/2239\/66956303\/eschf_12_3_2239.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/12\/3\/2239\/66956303\/eschf_12_3_2239.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T09:27:44Z","timestamp":1771406864000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eschf\/article\/12\/3\/2239\/8488366"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,26]]},"references-count":12,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,2,26]]},"published-print":{"date-parts":[[2025,6,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ehf2.15248","relation":{},"ISSN":["2055-5822"],"issn-type":[{"value":"2055-5822","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,6]]},"published":{"date-parts":[[2025,2,26]]},"assertion":[{"value":"2024-11-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}