{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T21:35:37Z","timestamp":1794000937621,"version":"4.8.0"},"reference-count":50,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2024,10,29]]},"abstract":"<jats:p>\n            The classification of cardiogenic shock (CS) has evolved from a singular cold-and wet-hemodynamic profile. Data from registries and clinical trials have contributed to a broader recognition that although all patients with CS have insufficient cardiac output leading to end organ hypoperfusion, there is considerable variability in CS acuity, underlying etiologies, volume status, and systemic vascular resistance. Mixed CS can be broadly categorized as\n            <jats:italic toggle=\"yes\">CS with at least 1 additional shock state<\/jats:italic>\n            . Mixed CS states are now the second leading cause of shock in contemporary coronary intensive care units, but there is little high-quality evidence to guide routine care, and there are no standardized classification frameworks or well-established hemodynamic definitions. This primer summarizes the current epidemiology and proposes a classification framework and invasive hemodynamic parameters to guide categorization that could be applied to help better phenotype patients captured in registries and trials, as well as guide management of mixed CS states.\n          <\/jats:p>","DOI":"10.1161\/circulationaha.124.069508","type":"journal-article","created":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T18:00:46Z","timestamp":1730138446000},"page":"1459-1468","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":52,"title":["Mixed Cardiogenic Shock: A Proposal for Standardized Classification, a Hemodynamic Definition, and Framework for Management"],"prefix":"10.1161","volume":"150","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6688-828X","authenticated-orcid":true,"given":"Sean","family":"van Diepen","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine and Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, Canada (S.v.D., J.M.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janine","family":"P\u00f6ss","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine\/Cardiology, Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Germany (J.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janek M.","family":"Senaratne","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine and Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, Canada (S.v.D., J.M.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Gage","sequence":"additional","affiliation":[{"name":"Centennial Medical Center, Nashville, TN (A.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9589-5382","authenticated-orcid":true,"given":"David A.","family":"Morrow","sequence":"additional","affiliation":[{"name":"Levine Cardiac Intensive Care Unit, TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (D.A.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.120.006956"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.165.14.1643"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjacc\/zuad095"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.119.006746"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.009684"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2013.12.007"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/08850666211061472"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2012.03.018"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCE.0000000000000637"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000525"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.123.064527"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.119.005618"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2020.10.054"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0735-1097(00)00874-3"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9113384"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2021.08.014"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMvcm1212416"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31823bc5f9"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31828a67b2"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2013.01.004"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehq220"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2022.12.004"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.008377"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(16)00046-1"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2018.08.1037"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1097\/ec9.0000000000000060"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2022.01.018"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2023.08.007"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2023.08.031"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1177\/0885066619878125"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000215112.84523.F0"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199811000-00016"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.008169"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.122.009714"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2019.11.015"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2020.08.012"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2023.04.007"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199908263410901"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1710261"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0907118"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.04.052"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa067373"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjacc\/zuad138"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-016-1570-4"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000002425"},{"key":"e_1_3_3_47_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.08.022"},{"key":"e_1_3_3_48_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezu462"},{"key":"e_1_3_3_49_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31828a2370"},{"key":"e_1_3_3_50_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000001178"},{"key":"e_1_3_3_51_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000001933"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.124.069508","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T14:32:48Z","timestamp":1748529168000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.124.069508"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,29]]},"references-count":50,"journal-issue":{"issue":"18","published-print":{"date-parts":[[2024,10,29]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.124.069508"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.124.069508","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,29]]},"assertion":[{"value":"2024-03-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}