{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T01:26:33Z","timestamp":1767921993804,"version":"3.49.0"},"reference-count":24,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T00:00:00Z","timestamp":1694044800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Studies had previously identified three cardiogenic shock (CS) phenotypes (cardiac-only, cardiorenal, and cardiometabolic). Therefore, we aimed to understand better the hemodynamic profiles of these phenotypes in acute myocardial infarction-CS (AMI-CS) using pulmonary artery catheter (PAC) data to better understand the AMI-CS heterogeneity. Methods: We analyzed the PAC data of 309 patients with AMI-CS. The patients were classified by SCAI shock stage, congestion profile, and phenotype. In addition, 24 h hemodynamic PAC data were obtained. Results: We identified three AMI-CS phenotypes: cardiac-only (43.7%), cardiorenal (32.0%), and cardiometabolic (24.3%). The cardiometabolic phenotype had the highest mortality rate (70.7%), followed by the cardiorenal (52.5%) and cardiac-only (33.3%) phenotypes, with significant differences (p &lt; 0.001). Right atrial pressure (p = 0.001) and pulmonary capillary wedge pressure (p = 0.01) were higher in the cardiometabolic and cardiorenal phenotypes. Cardiac output, index, power, power index, and cardiac power index normalized by right atrial pressure and left-ventricular stroke work index were lower in the cardiorenal and cardiometabolic than in the cardiac-only phenotypes. We found a hazard ratio (HR) of 2.1 for the cardiorenal and 3.3 for cardiometabolic versus the cardiac-only phenotypes (p &lt; 0.001). Also, multi-organ failure, acute kidney injury, and ventricular tachycardia\/fibrillation had a significant HR. Multivariate analysis revealed that CS phenotypes retained significance (p &lt; 0.001) when adjusted for the Society for Cardiovascular Angiography &amp; Interventions score (p = 0.011) and \u2206congestion (p = 0.028). These scores independently predicted mortality. Conclusions: Accurate patient prognosis and treatment strategies are crucial, and phenotyping in AMI-CS can aid in this effort. PAC profiling can provide valuable prognostic information and help design new trials involving AMI-CS.<\/jats:p>","DOI":"10.3390\/jcm12185818","type":"journal-article","created":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T10:09:50Z","timestamp":1694081390000},"page":"5818","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Invasive Phenoprofiling of Acute-Myocardial-Infarction-Related Cardiogenic Shock"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6019-2644","authenticated-orcid":false,"given":"Jorge A.","family":"Ortega-Hern\u00e1ndez","sequence":"first","affiliation":[{"name":"Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez, Coronary Care Unit, Juan Badiano 1, Secci\u00f3n XVI, Tlalpan, Ciudad De Mexico 14080, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4370-9963","authenticated-orcid":false,"given":"H\u00e9ctor","family":"Gonz\u00e1lez-Pacheco","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez, Coronary Care Unit, Juan Badiano 1, Secci\u00f3n XVI, Tlalpan, Ciudad De Mexico 14080, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jardiel","family":"Arg\u00fcello-Bola\u00f1os","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez, Coronary Care Unit, Juan Badiano 1, Secci\u00f3n XVI, Tlalpan, Ciudad De Mexico 14080, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5245-0623","authenticated-orcid":false,"given":"Jos\u00e9 Omar","family":"Arenas-D\u00edaz","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez, Coronary Care Unit, Juan Badiano 1, Secci\u00f3n XVI, Tlalpan, Ciudad De Mexico 14080, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"P\u00e9rez-L\u00f3pez","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez, Coronary Care Unit, Juan Badiano 1, Secci\u00f3n XVI, Tlalpan, Ciudad De Mexico 14080, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario Ram\u00f3n","family":"Garc\u00eda-Arias","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez, Coronary Care Unit, Juan Badiano 1, Secci\u00f3n XVI, Tlalpan, Ciudad De Mexico 14080, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4865-4869","authenticated-orcid":false,"given":"Rodrigo","family":"Gopar-Nieto","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez, Coronary Care Unit, Juan Badiano 1, Secci\u00f3n XVI, Tlalpan, Ciudad De Mexico 14080, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Sierra-Lara-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez, Coronary Care Unit, Juan Badiano 1, Secci\u00f3n XVI, Tlalpan, Ciudad De Mexico 14080, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diego","family":"Araiza-Garaygordobil","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez, Coronary Care Unit, Juan Badiano 1, Secci\u00f3n XVI, Tlalpan, Ciudad De Mexico 14080, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Manzur-Sandoval","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez, Coronary Care Unit, Juan Badiano 1, Secci\u00f3n XVI, Tlalpan, Ciudad De Mexico 14080, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6155-2704","authenticated-orcid":false,"given":"Luis Alejandro","family":"Soliz-Uriona","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez, Coronary Care Unit, Juan Badiano 1, Secci\u00f3n XVI, Tlalpan, Ciudad De Mexico 14080, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gloria Monserrath","family":"Astudillo-Alvarez","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez, Coronary Care Unit, Juan Badiano 1, Secci\u00f3n XVI, Tlalpan, Ciudad De Mexico 14080, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaime","family":"Hern\u00e1ndez-Montfort","sequence":"additional","affiliation":[{"name":"Advanced Heart Failure and Recovery Program for Central Texas Baylor Scott & White Health, 302 University Blvd, Round Rock, TX 78665, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Arias-Mendoza","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez, Coronary Care Unit, Juan Badiano 1, Secci\u00f3n XVI, Tlalpan, Ciudad De Mexico 14080, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1016\/j.jacc.2022.01.018","article-title":"SCAI SHOCK Stage Classification Expert Consensus Update: A Review and Incorporation of Validation Studies","volume":"79","author":"Naidu","year":"2022","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"20085","DOI":"10.1161\/JAHA.120.020085","article-title":"Phenotyping Cardiogenic Shock","volume":"10","author":"Zweck","year":"2021","journal-title":"J. Am. Heart Assoc."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Zweck, E., Kanwar, M., Li, S., Sinha, S.S., Garan, A.R., Hernandez-Montfort, J., Zhang, Y., Li, B., Baca, P., and Dieng, F. Clinical Course of Patients in Cardiogenic Shock Stratified by Phenotype. JACC Heart Fail., 2023. in press.","DOI":"10.1016\/j.jchf.2023.05.007"},{"key":"ref_4","first-page":"745","article-title":"Dynamic Invasive Hemodynamic Congestion Profile Impacts Acute Myocardial Infarction Complicated by Cardiogenic Shock Outcomes: A Real-World Single-Center Study","volume":"29","year":"2022","journal-title":"J. Card. Fail."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1016\/j.jchf.2020.08.012","article-title":"Complete Hemodynamic Profiling with Pulmonary Artery Catheters in Cardiogenic Shock Is Associated with Lower In-Hospital Mortality","volume":"8","author":"Garan","year":"2020","journal-title":"JACC Heart Fail."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e007099","DOI":"10.1161\/CIRCHEARTFAILURE.120.007099","article-title":"Invasive Hemodynamic Assessment and Classification of In-Hospital Mortality Risk Among Patients with Cardiogenic Shock","volume":"13","author":"Thayer","year":"2020","journal-title":"Circ. Heart Fail."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1097\/MCC.0000000000000838","article-title":"Hemodynamic Monitoring in Cardiogenic Shock","volume":"27","author":"Vandyck","year":"2021","journal-title":"Curr. Opin. Crit. Care"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e000960","DOI":"10.1136\/openhrt-2018-000960","article-title":"Cardiogenic Shock: Evolving Definitions and Future Directions in Management","volume":"6","author":"Jones","year":"2019","journal-title":"Open Heart"},{"key":"ref_9","first-page":"1","article-title":"KDIGO Clinical Practice Guideline for Acute Kidney Injury","volume":"2","author":"Kellum","year":"2012","journal-title":"Kidney Int. Suppl."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1619","DOI":"10.1007\/s00134-002-1491-3","article-title":"The Multiple Organ Dysfunction Score (MODS) versus the Sequential Organ Failure Assessment (SOFA) Score in Outcome Prediction","volume":"28","author":"Bota","year":"2002","journal-title":"Intensive Care Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"3920","DOI":"10.1002\/ehf2.14093","article-title":"Prognostic Value of Right Atrial Pressure-Corrected Cardiac Power Index in Cardiogenic Shock","volume":"9","author":"Baldetti","year":"2022","journal-title":"ESC Heart Fail."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"E011642","DOI":"10.1161\/CIRCIMAGING.120.011642","article-title":"Noninvasive Echocardiographic Left Ventricular Stroke Work Index Predicts Mortality in Cardiac Intensive Care Unit Patients","volume":"13","author":"Jentzer","year":"2020","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1002\/ejhf.260","article-title":"Clinical Picture and Risk Prediction of Short-Term Mortality in Cardiogenic Shock","volume":"17","author":"Harjola","year":"2015","journal-title":"Eur. J. Heart Fail."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1002\/ejhf.872","article-title":"Organ Dysfunction, Injury and Failure in Acute Heart Failure: From Pathophysiology to Diagnosis and Management. A Review on Behalf of the Acute Heart Failure Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC)","volume":"19","author":"Harjola","year":"2017","journal-title":"Eur. J. Heart Fail."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.cardfail.2017.10.009","article-title":"Right Ventricular Dysfunction in Acute Myocardial Infarction Complicated by Cardiogenic Shock: A Hemodynamic Analysis of the Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock (SHOCK) Trial and Registry","volume":"24","author":"Lala","year":"2018","journal-title":"J. Card. Fail."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1016\/j.jacc.2008.05.068","article-title":"Importance of Venous Congestion for Worsening of Renal Function in Advanced Decompensated Heart Failure","volume":"53","author":"Mullens","year":"2009","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2199","DOI":"10.1016\/j.jacc.2016.02.058","article-title":"Reduced Cardiac Index Is Not the Dominant Driver of Renal Dysfunction in Heart Failure","volume":"67","author":"Hanberg","year":"2016","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1842","DOI":"10.1016\/j.jacc.2017.01.047","article-title":"Management of Ventricular Arrhythmias in Patients with Advanced Heart Failure","volume":"69","author":"Santangeli","year":"2017","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Zeymer, U., Freund, A., Hochadel, M., Ostadal, P., Belohlavek, J., Rokyta, R., Massberg, S., Brunner, S., L\u00fcsebrink, E., and Flather, M. (2023). Venoarterial Extracorporeal Membrane Oxygenation in Patients with Infarct-Related Cardiogenic Shock: An Individual Patient Data Meta-Analysis of Randomised Trials. Lancet.","DOI":"10.1016\/S0140-6736(23)01607-0"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"451","DOI":"10.4244\/EIJ-D-20-01296","article-title":"Management of Cardiogenic Shock","volume":"17","author":"Thiele","year":"2021","journal-title":"EuroIntervention"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1038\/nbt1406","article-title":"What Is the Expectation Maximization Algorithm?","volume":"26","author":"Do","year":"2008","journal-title":"Nat. Biotechnol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1080\/24709360.2017.1306156","article-title":"Multi-State Models and Missing Covariate Data: Expectation-Maximization Algorithm for Likelihood Estimation","volume":"1","author":"Lou","year":"2017","journal-title":"Biostat. Epidemiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1016\/j.jacc.2012.10.005","article-title":"2013 ACCF\/AHA Key Data Elements and Definitions for Measuring the Clinical Management and Outcomes of Patients with Acute Coronary Syndromes and Coronary Artery Disease","volume":"61","author":"Cannon","year":"2013","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1097\/CCM.0000000000001375","article-title":"Validity of a Modified Sequential Organ Failure Assessment Score Using the Richmond Agitation-Sedation Scale","volume":"44","author":"Vasilevskis","year":"2016","journal-title":"Crit. Care Med."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/18\/5818\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:46:40Z","timestamp":1760129200000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/18\/5818"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,7]]},"references-count":24,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2023,9]]}},"alternative-id":["jcm12185818"],"URL":"https:\/\/doi.org\/10.3390\/jcm12185818","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,7]]}}}