{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T06:18:44Z","timestamp":1783491524642,"version":"3.55.0"},"reference-count":13,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cardiogenic Shock can affect significantly the survival in patients with AMI or ADHF.Mechanical circulatory support is the keystone of treatment beyond standard care to improve end organ perfusion and potentially survival.Hemodynamics progression during support has not been well studied. This retrospective cohort study aims to evaluate the patterns, timingand outcomes of therapeutic circulatory support escalation and de-escalation in patients admitted to a tertiary referral cardiogenic shockcenter.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were collected for the patients over the age of 18 that had implantation of the microaxial flow pump at the University of Iowa HealthCare. Data includes invasive hemodynamics during admission, 24\u2005h and 72\u2005h post intervention along different modalities ofmechanical and pharmacological hemodynamic support in addition to patient history and baseline characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 110 patients were included in the analysis, 53 patients (48.18%) survived. The average Impella power level was significantly lowerin the survival group (6.21 vs. 6.92,\n                      <jats:italic>p<\/jats:italic>\n                      =0.01) despite similar flow rates between groups (3.16 L\/min vs. 3.08 L\/min,\n                      <jats:italic>p<\/jats:italic>\n                      =0.31). 72\u2005h Cardiacpower output was significantly better within survivors (1.15 watts vs. 0.69 watts, p&amp;lt;0.01). Multivariable logistic regression analysis identifiedelevated cardiac power at 72\u2005h post intervention as an independent predictor of survival among patients with GCS during hospitalization(OR 0.09; 95% CI 0.02-0.45;\n                      <jats:italic>p<\/jats:italic>\n                      =0.03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our data indicate that sustained hemodynamic improvement, particularly in cardiac power output, is associated with survival, independently ofthe absolute changes in Impella flow and power.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1720984","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:57:13Z","timestamp":1783490233000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Patterns of temporary mechanical circulatory support, escalation, de-escalation and outcomes in cardiogenic shock"],"prefix":"10.3389","volume":"13","author":[{"given":"Ibrahim","family":"Mortada","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Iowa","place":["Iowa City, IA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lovkesh","family":"Arora","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Iowa","place":["Iowa City, IA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Aguilar Pescozo","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Iowa","place":["Iowa City, IA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulino","family":"Alvarez","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Cleveland Clinic , , OH","place":["Cleveland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelos","family":"Soranidis","sequence":"additional","affiliation":[{"name":"Department of Clinical Therapeutics, National and Kapodistrian University of Athens","place":["Athens, Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandros","family":"Briasoulis","sequence":"additional","affiliation":[{"name":"Department of Clinical Therapeutics, National and Kapodistrian University of Athens","place":["Athens, Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernesto","family":"Ruiz Duque","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Iowa","place":["Iowa City, IA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2398","DOI":"10.3390\/jcm9082398","article-title":"Short- and long-term mortality trends in STEMI-cardiogenic shock over three decades (1989\u20132018): the ruti-STEMI-shock registry","volume":"9","author":"Garc\u00eda-Garc\u00eda","year":"2020","journal-title":"J Clin Med"},{"key":"B2","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1016\/j.ahj.2020.08.012","article-title":"Trends in first-time hospitalization, management, and short-term mortality in acute myocardial infarction-related cardiogenic shock from 2005 to 2017: a nationwide cohort study","volume":"229","author":"Lauridsen","year":"2020","journal-title":"Am Heart 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