{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T17:35:31Z","timestamp":1793208931881,"version":"4.5.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"University Medical Center Hamburg-Eppendorf, Germany","id":[{"id":"https:\/\/ror.org\/01zgy1s35","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Cardiogenic shock (CS) is often treated with catecholamines titrated to an adequate target mean arterial pressure (MAP) while minimizing adverse effects. We aim to assess the optimal catecholamine dose\/MAP balance in heart failure-associated CS (HF-CS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with HF-CS were retrospectively enrolled from 16 tertiary centres in 5 European countries (2016\u20132021; NCT03313687). Dosage was quantified by inotropic scores (epinephrine, norepinephrine, and dobutamine). Associations of baseline and seven-day summarized dosage with intensive care unit (ICU) discharge (mixed-effects logistic regression) and 30-day mortality (Cox regression) were analysed. Potential catecholamine\/MAP target ratios for optimized outcomes were assessed in models adjusted for age, sex, pH, lactate and prior resuscitation, stratified by centre.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>N = 704 patients: median age 63\u202fyears, 74% male, 34% post-resuscitation, median lactate 5.2\u202fmmol\/l. Of these, 53% were discharged from ICU, 48% died within 30\u202fdays. Higher inotropic scores independently predicted a lower probability of ICU discharge (baseline score: OR 0.78 [95%-CI 0.69\u20130.88]; summarized score: OR 0.46 [0.38\u20130.56]; both P &amp;lt; .001) and higher risk of 30-day mortality (baseline score: HR 1.27 [1.15\u20131.40], summarized score HR 1.83 [1.60\u20132.09]; both P &amp;lt; .001). A score\/MAP ratio &amp;lt;0.403\u2005\u00b5g\/kg\/min\/mmHg was associated with higher ICU discharge odds (ceiling effect); a &amp;lt; 0.426\u2005\u00b5g\/kg\/min\/mmHg with lower 30-day mortality hazards (no ceiling effect). Lowering catecholamine doses by accepting reduced MAP targets was linked to better outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In HF-CS, higher catecholamine support independently associates with worse outcomes. Accepting lower blood pressure targets to reduce catecholamine dosage may improve outcomes. Validation in randomized controlled trials is urgently needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejhf\/xuag009","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T12:22:50Z","timestamp":1768220570000},"page":"694-702","source":"Crossref","is-referenced-by-count":4,"title":["Balancing blood pressure and catecholamine support is critical in heart failure-related cardiogenic shock patients"],"prefix":"10.1093","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4315-2533","authenticated-orcid":false,"given":"Benedikt N","family":"Beer","sequence":"first","affiliation":[{"name":"Department of Cardiology, University Medical Center Hamburg-Eppendorf , Martinistr 52, Hamburg 20246 ,","place":["Germany"]},{"name":"German Centre for Cardiovascular Research (DZHK) , Partner Site Hamburg\/Kiel\/L\u00fcbeck ,","place":["Germany"]},{"name":"Department of Clinical Science and Education, S\u00f6dersjukhuset, Karolinska Institutet , Stockholm ,","place":["Sweden"]},{"name":"Universit\u00e9 Paris Cit\u00e9 and Universit\u00e9 Sorbonne Paris Nord, Inserm, INRAE , Centre for Research in Epidemiology and Statistics (CRESS), Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9693-4622","authenticated-orcid":false,"given":"Caroline","family":"Kellner","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center Hamburg-Eppendorf , Martinistr 52, Hamburg 20246 ,","place":["Germany"]},{"name":"Center for Population Health Innovation (POINT), University Medical Center Hamburg-Eppendorf , Hamburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0076-2211","authenticated-orcid":false,"given":"Jonas","family":"Sundermeyer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center Hamburg-Eppendorf , Martinistr 52, Hamburg 20246 ,","place":["Germany"]},{"name":"German Centre for Cardiovascular Research (DZHK) , Partner Site Hamburg\/Kiel\/L\u00fcbeck ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Besch","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center Hamburg-Eppendorf , Martinistr 52, Hamburg 20246 ,","place":["Germany"]},{"name":"German Centre for Cardiovascular Research (DZHK) , Partner Site Hamburg\/Kiel\/L\u00fcbeck ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0992-0236","authenticated-orcid":false,"given":"Angela","family":"Dettling","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center Hamburg-Eppendorf , Martinistr 52, Hamburg 20246 ,","place":["Germany"]},{"name":"German Centre for Cardiovascular Research (DZHK) , Partner Site Hamburg\/Kiel\/L\u00fcbeck ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0823-2834","authenticated-orcid":false,"given":"Marvin","family":"Kriz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center Hamburg-Eppendorf , Martinistr 52, Hamburg 20246 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1881-0197","authenticated-orcid":false,"given":"Paulus","family":"Kirchhof","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center Hamburg-Eppendorf , Martinistr 52, Hamburg 20246 ,","place":["Germany"]},{"name":"German Centre for Cardiovascular Research (DZHK) , Partner Site Hamburg\/Kiel\/L\u00fcbeck ,","place":["Germany"]},{"name":"Institute of Cardiovascular Sciences, University of Birmingham , Birmingham ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6488-2362","authenticated-orcid":false,"given":"Stefan","family":"Blankenberg","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center Hamburg-Eppendorf , Martinistr 52, Hamburg 20246 ,","place":["Germany"]},{"name":"German Centre for Cardiovascular Research (DZHK) , Partner Site Hamburg\/Kiel\/L\u00fcbeck ,","place":["Germany"]},{"name":"Universit\u00e9 Paris Cit\u00e9 and Universit\u00e9 Sorbonne Paris Nord, Inserm, INRAE , Centre for Research in Epidemiology and Statistics (CRESS), Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Letizia","family":"Bertoldi","sequence":"additional","affiliation":[{"name":"Cardio Center, Humanitas Clinical and Research Center\u2014IRCCS , Rozzano, Milan 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