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Clinical Management of Cardiogenic Shock and Cardiac Arrest: 2nd Edition

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 20 January 2026 | Viewed by 1767

Special Issue Editor


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Guest Editor
Advanced Heart Disease, Replacement and Recovery Program, Baylor Scott and White Health, Temple, TX, USA
Interests: cardiogenic shock; heart replacement; heart recovery; transitions in mechanical circulatory support
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Special Issue Information

Dear colleagues,

It is my pleasure to invite you to contribute to this Special Issue, titled “Clinical Management of Cardiogenic Shock and Cardiac Arrest: 2nd Edition”. This is a new edition; we published six papers in the first edition. For more details, please visit https://www.mdpi.com/journal/jcm/special_issues/0448MPMR3Z.

Cardiogenic shock remains a complex disease entity, associated with high mortality, that compromises the well-being of patients and caregivers across healthcare systems across the world. Increased recognition of the spectral nature of cardiogenic shock has led to a movement towards early interventions associated with diagnostic profiles that inform and tailor disease-specific interventions. Importantly, severe refractory cardiogenic shock, complicated by cardiac arrest, carries an exceedingly high mortality and, paradoxically, most of the contemporary interventions are oftentimes utilized. In this context, classifications, team-based approaches, and systems of care that allow for the early recognition of the disease have emerged in an attempt to halt hemometabolic involvement and provide transitions, including heart recovery or remission. Important progress has been made with the use of distinct temporary mechanical circulatory support devices tailored to right, left, or biventricular support; however, knowledge gaps remain on the multiple associated clinical interventions required to help patients transition to longitudinal well-being. Aspects related to decongestion, weaning, and the escalation of temporary MCS, as well as strategies that promote ambulation, nutrition, and end-organ recovery (including neuroprotection after cardiac arrest), are some of the ongoing clinical questions that need to be addressed to best understand this rapidly evolving field and guide clinicians. In this Special Issue, we invite authors to submit papers on the clinical advances in the management of cardiogenic shock and cardiac arrest.

Dr. Jaime A. Hernández-Montfort
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

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Keywords

  • cardiogenic shock
  • cardiac arrest
  • temporary mechanical circulatory support
  • ECMO
  • transitions
  • heart recovery
  • heart replacement

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Related Special Issue

Published Papers (3 papers)

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Research

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16 pages, 1628 KB  
Article
Association of Scene Time Interval and Field Arrival to Epinephrine Administration Time with Outcomes in Cardiac Arrest
by Yohei Okada, Ki Jeong Hong, Marcus Eng Hock Ong, Sang Do Shin, Kyoung Jun Song, Jeong Ho Park, Young Sun Ro, Nur Shahidah, Shir Lynn Lim and Fahad Javaid Siddiqui
J. Clin. Med. 2025, 14(18), 6645; https://doi.org/10.3390/jcm14186645 (registering DOI) - 20 Sep 2025
Abstract
Background/Objectives: The association of scene time interval (STI) and field arrival to epinephrine administration time (FET) with outcomes in out-of-hospital cardiac arrest (OHCA) is unknown. The goal of this investigation is to assess the association of STI and FET with outcomes in OHCA. [...] Read more.
Background/Objectives: The association of scene time interval (STI) and field arrival to epinephrine administration time (FET) with outcomes in out-of-hospital cardiac arrest (OHCA) is unknown. The goal of this investigation is to assess the association of STI and FET with outcomes in OHCA. Methods: All adult OHCA cases with prehospital epinephrine administration in South Korea and Singapore were included. STI was divided into short and long stay based on the median value of each country. FET was categorized into early (<10 min) and late groups. We performed multivariable logistic regression for survival to discharge and good neurological recovery. Cases were grouped into short stay early epinephrine (SS-EE), short stay late epinephrine (SS-LE), long stay early epinephrine (LS-EE), and long stay late epinephrine (LS-LE) (reference). Interaction analysis with STI and FET for outcomes was conducted. Results: A total of 18,867 cases from South Korea and 4184 cases from Singapore were included. Adjusted odds ratio (AOR) for survival to discharge was 2.14 (95% CI: 1.18–2.25) in SS-EE, 1.15 (0.94–1.40) in SS-LE, and 1.82 (1.45–2.28) in LS-EE compared to LS-LE in South Korea with similar results for Singapore. SS-EE and LS-EE were also associated with good neurologic recovery. Interaction analysis showed that early epinephrine injection in short stay and long stay was associated with better outcomes. But short STI was not associated with better outcomes in early and late epinephrine groups. Conclusions: Early epinephrine administration was associated with higher survival to discharge irrespective of the scene time interval. Full article
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10 pages, 239 KB  
Article
Prolonged Impella 5.5 Support in Patients with Cardiogenic Shock: A Single-Center Retrospective Analysis
by Ioana Dumitru, Jonathan DeWolf, Maria Sevillano, LeeAndra Schnell, Hiram Bezerra and Debbie Rinde-Hoffman
J. Clin. Med. 2025, 14(16), 5631; https://doi.org/10.3390/jcm14165631 - 8 Aug 2025
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Abstract
Background: Patients in cardiogenic shock (CS) often require prolonged mechanical circulatory support lasting longer than 14 days. Prolonged support with Impella 5.5 can improve outcomes in these patients. Here, we describe our experience with prolonged Impella 5.5 support. Methods: From January 2023 to [...] Read more.
Background: Patients in cardiogenic shock (CS) often require prolonged mechanical circulatory support lasting longer than 14 days. Prolonged support with Impella 5.5 can improve outcomes in these patients. Here, we describe our experience with prolonged Impella 5.5 support. Methods: From January 2023 to June 2024, 64 patients receiving Impella 5.5 support for more than 14 days were identified. Information including demographics, heart failure etiology, and hospital course were collected. Results: Of the 64 patients identified, 54 were male, with an average age of 55.9 years. One patient was classified as SCAI class C, 41 as SCAI class D, and 22 as SCAI class E. Heart failure etiologies included 41 patients with non-ischemic cardiomyopathy, 10 with ischemic cardiomyopathy, 10 with acute myocardial infarction, 1 with cardiac allograft rejection, 1 with post-cavotricuspid isthmus ablation, and 1 with post-cardiotomy (aortic root replacement) CS. The average duration of Impella 5.5 support was 27.1 days. Escalation to Impella 5.5 was observed in 26 patients, with 15 having escalated from intra-aortic balloon pump and 11 from Impella CP. Overall survival, including heart recovery, orthotopic heart transplantation (OHT), or left ventricular assist device (LVAD), was 81.3% (52/64) in patients with Impella 5.5. Patients were discharged after OHT (27/64), cardiac recovery (13/64), or durable LVAD placement (12/64), and 12 patients expired. Conclusions: Our data suggest that Impella 5.5 provides durable support for patients beyond the 14-day period currently approved by the FDA for CS management. Further evaluation of long-term Impella 5.5 support for cardiac recovery or as a bridge to advanced therapies should be considered. Full article

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9 pages, 1563 KB  
Case Report
High Profile Transvalvular Pump Assisted Recovery for Takotsubo Cardiomyopathy: A Case Series
by Jordan Young, Patrick McGrade, Jaime Hernandez-Montfort and Jerry Fan
J. Clin. Med. 2025, 14(9), 3225; https://doi.org/10.3390/jcm14093225 - 6 May 2025
Viewed by 756
Abstract
Background: Stress-induced cardiomyopathy (SI-CM) is a transient left ventricular dysfunction triggered by emotional or physical stress, often resolving with supportive care. However, severe cases may progress to cardiogenic shock (CS), requiring mechanical circulatory support (MCS). High-profile transvalvular pumps (HPTP), a form of percutaneous [...] Read more.
Background: Stress-induced cardiomyopathy (SI-CM) is a transient left ventricular dysfunction triggered by emotional or physical stress, often resolving with supportive care. However, severe cases may progress to cardiogenic shock (CS), requiring mechanical circulatory support (MCS). High-profile transvalvular pumps (HPTP), a form of percutaneous ventricular assist device, offer promising hemodynamic support in acute heart failure. This report explores HPTP use in SI-CM-related CS through two complex clinical cases. Case Summary: Two elderly female patients presented with severe CS secondary to apical-variant SI-CM. Case 1 involved a 67-year-old woman with sepsis, colonic perforation, and recurrent SI-CM, leading to profound low-output shock despite multiple vasopressors and inotropes. HPTP was implanted via the axillary artery, allowing for surgical management of intra-abdominal pathology and eventual cardiac recovery. Case 2 featured a 77-year-old woman with multifocal pneumonia, severe mitral regurgitation, and complete heart block. HPTP implantation stabilized her hemodynamics, facilitated extubation, and led to full recovery of ventricular function. Results: Both patients showed marked improvement in cardiac output and systemic perfusion following HPTP insertion. Echocardiograms post-device removal revealed normalization of left ventricular ejection fraction (55–64%). Hemodynamic data confirmed reduced pulmonary capillary wedge pressure and systemic vascular resistance. Conclusion: These cases highlight the potential of HPTP in managing SI-CM-related CS, especially when traditional therapies are inadequate or contraindicated. HPTP can rapidly restore hemodynamic stability and support myocardial recovery. While current data are limited, these observations underscore the need for broader investigation into the role of HPTP in this setting. Full article
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