{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T16:03:16Z","timestamp":1781539396624,"version":"3.54.5"},"reference-count":41,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2023,11,20]],"date-time":"2023-11-20T00:00:00Z","timestamp":1700438400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,11,20]],"date-time":"2023-11-20T00:00:00Z","timestamp":1700438400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Hamburg-Eppendorf (UKE)"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Res Cardiol"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Currently, use of mechanical circulatory support (MCS) in non-ischaemic cardiogenic shock (CS) is predominantly guided by shock-specific markers, and not by markers of cardiac function. We hypothesise that left ventricular ejection fraction (LVEF) can identify patients with a higher likelihood to benefit from MCS and thus help to optimise their expected benefit.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Patients with non-ischaemic CS and available data on LVEF from 16 tertiary-care centres in five countries were analysed. Cox regression models were fitted to evaluate the association between LVEF and mortality, as well as the interaction between LVEF, MCS use and mortality.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p><jats:italic>N<\/jats:italic>\u2009=\u2009807 patients were analysed: mean age 63 [interquartile range (IQR) 51.5\u201372.0] years, 601 (74.5%) male, lactate 4.9 (IQR 2.6\u20138.5) mmol\/l, LVEF 20 (IQR 15\u201330) %. Lower LVEF was more frequent amongst patients with more severe CS, and MCS was more likely used in patients with lower LVEF. There was no association between LVEF and 30-day mortality risk in the overall study cohort. However, there was a significant interaction between MCS use and LVEF, indicating a lower 30-day mortality risk with MCS use in patients with LVEF\u2009\u2264\u200920% (hazard ratio 0.72, 95% confidence interval 0.51\u20131.02 for LVEF\u2009\u2264\u200920% vs. hazard ratio 1.31, 95% confidence interval 0.85\u20132.01 for LVEF\u2009&gt;\u200920%, interaction-<jats:italic>p<\/jats:italic>\u2009=\u20090.017).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>This retrospective study may indicate a lower mortality risk with MCS use only in patients with severely reduced LVEF. This may propose the inclusion of LVEF as an adjunctive parameter for MCS decision-making in non-ischaemic CS, aiming to optimise the benefit\u2013risk ratio.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphical abstract<\/jats:title>\n                <jats:p>Impact of left ventricular ejection fraction on mortality and use of mechanical circulatory support in non-ischaemic cardiogenic shock. Hazard ratio for 30-day mortality across the LVEF continuum, adjusted for age, sex, SCAI shock stage, worst value of lactate and pH within 6\u00a0h, prior resuscitation and mechanical ventilation during the index shock event. LVEF: Left ventricular ejection fraction; MCS: Mechanical circulatory support; HR: Hazard ratio; CI: Confidence interval.<\/jats:p>\n                \n              <\/jats:sec>","DOI":"10.1007\/s00392-023-02332-y","type":"journal-article","created":{"date-parts":[[2023,11,20]],"date-time":"2023-11-20T11:02:16Z","timestamp":1700478136000},"page":"570-580","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Association between left ventricular ejection fraction, mortality and use of mechanical circulatory support in patients with non-ischaemic cardiogenic shock"],"prefix":"10.1007","volume":"113","author":[{"given":"Jonas","family":"Sundermeyer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Kellner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedikt 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L.F.B. reports speaker fees from Abiomed, outside of the submitted work. S.B. reports grants and personal fees from Abbott Diagnostics, Bayer, Siemens, Thermo Fisher, grants from Singulex, personal fees from Abbott, AstraZeneca, Amgen, Medtronic, Pfizer, Roche, Siemens Diagnostics, Novartis, outside of the submitted work. J.D. received speaker fees from Astra-Zeneca, Boehringer-Ingelheim and Bayer. D.E. reports speaker fees from Abiomed, Biotronik and Daiichi sankyo, outside of the submitted work. P.K. was partially supported by European Union AFFECT-AF (grant agreement 847770), and MAESTRIA (grant agreement 965286), British Heart Foundation (PG\/17\/30\/32961; PG\/20\/22\/35093; AA\/18\/2\/34218), German Centre for Cardiovascular Research supported by the German Ministry of Education and Research (DZHK), Deutsche Forschungsgemeinschaft (Ki 509167694), and Leducq Foundation; receives research support for basic, translational, and clinical research projects from European Union, British Heart Foundation, Leducq Foundation, Medical Research Council (UK), and German Centre for Cardiovascular Research, from several drug and device companies active in atrial fibrillation, and has received honoraria from several such companies in the past, but not in the last three years; is listed as inventor on two issued patents held by University of Hamburg (Atrial Fibrillation Therapy WO 2015140571, Markers for Atrial Fibrillation WO 2016012783). S.K. received research support from Cytosorbents and Daiichi Sankyo. He also received lecture fees from ADVITOS, Biotest, Daiichi Sankyo, Fresenius Medical Care, Gilead, Mitsubishi Tanabe Pharma, MSD, Pfizer, Shionogi and Zoll. He received consultant fees from Fresenius, Gilead, MSD and Pfizer. P.L. received speaker honoraria and consulting fees from Astra Zeneca, Bayer, Pfizer, Edwards Lifesciences, and research honoraria from Edwards Lifesciences, outside of the submitted work. S.M.-W. reports Abiomed unrestricted grant for JenaMacs trial. Speakers honoraria: Abiomed, Boston Scientific, Pfizer, Daichi Sankyo, outside of the submitted work. M.O. reports speaker honoraria and travel compensations from companies Abbott Medical, AstraZeneca, Abiomed, Bayer vital, BIOTRONIK, Bristol-Myers Squibb, CytoSorbents, Daiichi Sankyo Deutschland, Edwards Lifesciences Services, Sedana Medical. F.P. consultant for Abiomed. T.R. received speaker honoraria and consulting fees from Astra Zeneca, Bayer, Pfizer, Daiichi Sankyo. None of them was related to this study. C.S. reports speaker honoraria from AstraZeneca, outside the submitted work. P.C.S. received honoraria for lectures\/consulting from Novartis, Vifor, Bayer, Pfizer, Boehringer Ingelheim, AstraZeneca, Cardior, BMS, Abiomed, Pharmacosmos and Amgen not related to this article; and research support for the department from Boehringer Ingelheim, Edwards and Abiomed not related to this article. D.W. reports speaker fees from Abiomed, AstraZeneca, Bayer, Berlin-Chemie, Boehringer Ingelheim, Novartis and Medtronic, outside of the submitted work. E.B.W. received speaker honoraria and consulting fees from Amarin, Amgen, AstraZeneca, Bayer, Boehringer-Ingelheim, CVRx, Daiichi Sankyo, and Novartis, and a research grant from Boehringer-Ingelheim of outside the submitted work. All other authors did not declare a conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}