NONINVASIVE HEMODYNAMIC ASSESSMENT AND N-TERMINAL PRO-BNP FOR PREDICTING SHOCK SEVERITY AND MORTALITY IN CARDIOGENIC SHOCK: A PROSPECTIVE STUDY
DOI:
https://doi.org/10.48047/Keywords:
Cardiogenic shock, SCAI shock stages, echocardiographic parameters, hemodynamic assessment, mortality prediction.Abstract
Background: Cardiogenic shock (CS) remains a critical condition with high mortality rates, necessitating improved understanding and risk stratification. The Society for Cardiovascular Angiography and Interventions (SCAI) developed a shock severity classification for CS
patients, yet the precise relationship between noninvasive hemodynamic and echocardiographic parameters and SCAI shock stages remains unclear.
Methods: This prospective study, conducted from September 2021 to October 2022, included 190 adult CS patients in cardiac intensive care units. They were categorized according to SCAI shock stages. Various clinical, laboratory, and echocardiographic parameters were
collected for analysis. Statistical methods were used to assess associations between these parameters and mortality.
Results: The study revealed significant findings. Patients with higher SCAI stages exhibited reduced stroke volume (SV) and stroke volume index (SVI), reflecting declining cardiac function. Left ventricular ejection fraction (LVEF) decreased with increasing SCAI stages,
indicating the severity of ventricular dysfunction. The SHOCK INDEX (heart rate/systolic blood pressure) increased with CS severity, showing its value as a risk assessment tool. Echocardiographic parameters, such as mitral E velocity and Mitral E/e' ratio, varied across
SCAI stages, contributing to the stratification of CS severity. NT-proBNP levels were significantly associated with higher SCAI stages, making it a reliable predictor of mortality.
Conclusion: This study enhances the understanding of CS by identifying associations between noninvasive hemodynamic and echocardiographic parameters and SCAI shock stages. It has clinical implications for risk assessment, early intervention, and tailored
treatment strategies to improve patient outcomes. These findings provide a foundation for further research and the potential for a more effective standard of care for CS patients.
