Impact of Pre-Existing History of Heart Failure on Patient Profile, Therapeutic Management, and Prognosis in Cardiogenic Shock: Insights from the FRENSHOCK Registry

Guillaume Schurtz (1) , Clément Delmas (2, 3) , Margaux Fenouillet (1) , François Roubille (4, 5) , Etienne Puymirat (6) , Laurent Bonello (7, 8) , Guillaume Leurent (9, 10) , Basile Verdier (1) , Bruno Levy (11, 12) , Julien Ternacle (13) , Brahim Harbaoui (14, 15, 16) , Gerald Vanzetto (17, 18) , Nicolas Combaret (19) , Benoît Lattuca (20, 21) , Cedric Bruel (22) , Jeremy Bourenne (23) , Vincent Labbé (24, 24) , Patrick Henry (25, 26) , Éric Bonnefoy-Cudraz (27, 28) , Nicolas Lamblin (29, 1) , Gilles Lemesle (30, 31, 1)

1 Institut Coeur Poumon [CHU Lille]
2 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
3 UPS/Inserm U1297 - I2MC - Institut des Maladies Métaboliques et Casdiovasculaires
4 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
5 Hôpital Arnaud de Villeneuve [CHRU Montpellier]
6 HEGP - Hôpital Européen Georges Pompidou [APHP]
7 C2VN - Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research
8 MARS cardio - Mediterranean Association for Research and Studies in Cardiology
9 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
10 LTSI - Laboratoire Traitement du Signal et de l'Image
11 Service de Réanimation Médicale [CHRU Nancy]
12 DCAC - Défaillance Cardiovasculaire Aiguë et Chronique
13 Hôpital Haut-Lévêque [CHU Bordeaux]
14 CREATIS - Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé
15 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
16 Hôpital de la Croix-Rousse [CHU - HCL]
17 LRB - Radiopharmaceutiques biocliniques
18 Département de cardiologie [CHU de Grenoble]
19 Service de Cardiologie Maladies Vasculaires [CHU Clermont-Ferrand]
20 CHU Nîmes - Hôpital Universitaire Carémeau [Nîmes]
21 IMAGINE - Initial MAnagement and prevention of acute orGan failures IN critically ill patiEnts
22 Centre hospitalier Saint-Joseph [Paris]
23 TIMONE - Hôpital de la Timone [CHU - APHM]
24 CHU Tenon [AP-HP]
25 Hôpital Lariboisière-Fernand-Widal [APHP]
26 MASCOT (UMR_S_942 / U942) - Marqueurs cardiovasculaires en situation de stress
27 CarMeN - Cardiovasculaire, métabolisme, diabétologie et nutrition
28 Hôpital Louis Pradel [CHU - HCL]
29 RID-AGE - Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167
30 RNMCD - Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U1011
31 FACT - Alliance française pour les essais cliniques cardio-vasculaires - French Alliance for Cardiovascular Trials

There is a large heterogeneity among patients presenting with cardiogenic shock (CS). It is crucial to better apprehend this heterogeneity in order to adapt treatments and improve prognoses in these severe patients. Notably, the presence (or absence) of a pre-existing history of chronic heart failure (CHF) at time of CS onset may be a significant part of this heterogeneity, and data focusing on this aspect are lacking. We aimed to compare CS patients with new-onset HF to those with worsening CHF in the multicenter FRENSHOCK registry. Altogether, 772 CS patients were prospectively included: 433 with a previous history of CHF and 339 without. Worsening CHF patients were older (68 +/− 13.4 vs. 62.7 +/− 16.2, p < 0.001) and had a greater burden of extra-cardiac comorbidities. At admission, acute myocardial infarction was predominantly observed in the new-onset HF group (49.9% vs. 25.6%, p < 0.001). When focusing on hemodynamic parameters, worsening CHF patients showed more congestion and higher ventricular filling pressures. Worsening CHF patients experienced higher in-hospital all-cause mortality (31.3% vs. 24.2%, p = 0.029). Our results emphasize the great heterogeneity of the patients presenting with CS. Worsening CHF patients had higher risk profiles, and this translated to a 30% increase in in-hospital all-cause mortality. The heterogeneity of this population prompts us to better determine the phenotype of CS patients to adapt their management.

Mots clés: Cardiogenic shock heart failure myocardial infarction mechanical circulatory support; Cardiogenic shock; Heart failure; Myocardial infarction; Cardiogenic shock heart failure myocardial infarction mechanical circulatory support; Mechanical circulatory support; Quantum many-body interaction Adaptive denoiser Quantum denoiser Quantum image processing Adaptive transformation; Quantum many-body interaction; Adaptive denoiser; Quantum denoiser; Quantum image processing; Adaptive transformation

Domaines: Cardiologie et système cardiovasculaire; Imagerie médicale; Biomécanique [physics.med-ph]

Guillaume Schurtz, Clément Delmas, Margaux Fenouillet, François Roubille, Etienne Puymirat, et al.. Impact of Pre-Existing History of Heart Failure on Patient Profile, Therapeutic Management, and Prognosis in Cardiogenic Shock: Insights from the FRENSHOCK Registry. Life, 2022, 12 (11), pp.1844. ⟨10.3390/life12111844⟩. ⟨hal-03872219⟩