AimsLeft ventricular unloading by percutaneous microaxial flow‐pump devices has been shown to improve survival in patients with cardiogenic shock (CS). The objective of the study is to examine whether Impella 5.0/5.5 (5+) support is effective in facilitating heart recovery, overall survival, and quality of life.Methods and resultsThis single‐centre retrospective study examined midterm (180 days) outcomes of patients with CS supported by Impella 5+ who achieved heart recovery. The primary endpoint was survival at 180 days and freedom from implantable cardioverter‐defibrillator (ICD), heart transplant/left ventricular assist device (LVAD), or readmission for heart failure. Functional status was assessed with New York Heart Association (NYHA) classification. Between June 2022 and April 2024, 20 patients with CS (64 ± 8.9 years, 80% male) received Impella 5+ and discharged with heart recovery. Before Impella placement, mean left ventricular ejection fraction (LVEF) was 19.2 ± 5.2%, 7 (35%) patients were SCAI stage C, 9 (45%) SCAI stage D, and 4 (20%) SCAI stage E, and the mean vasoactive‐inotropic score was 23.2 ± 38.0. The average duration of Impella support was 10.5 ± 8 days. At 180 days, 19 (95%) patients were alive, no patient received a heart transplant/LVAD, 40% were implanted with an ICD and there were two admissions for heart failure. The mean LVEF was 33.5 ± 10.7%, 5 (26.3%) patients were NYHA class I, 9 (47.4%) were NYHA class II, and 5 (26.3%) were NYHA class III. One patient died from a non‐cardiac cause.ConclusionImpella 5+ represents a promising treatment strategy for CS, providing high rates of sustained native heart recovery. A comprehensive platform of mechanical and pharmacological unloading is key.

中文翻译：

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Impella 5+ 心源性休克后自体心脏恢复患者的中期结局


目的经皮微轴流泵装置的左心室卸载已被证明可以提高心源性休克 （CS） 患者的生存率。该研究的目的是检查 Impella 5.0/5.5 （5+） 支持是否能有效促进心脏恢复、总体生存率和生活质量。方法和结果这项单中心回顾性研究检查了由 Impella 5+ 支持且实现心脏恢复的 CS 患者的中期 （180 天） 结局。主要终点是 180 天生存率和无植入式心律转复除颤器 （ICD） 、心脏移植/左心室辅助装置 （LVAD） 或因心力衰竭再入院。使用纽约心脏协会 （NYHA） 分类评估功能状态。2022 年 6 月至 2024 年 4 月期间，20 名 CS 患者 （64 ± 8.9 岁，80% 为男性） 接受了 Impella 5+ 治疗并随着心脏恢复而出院。放置 Impella 前，平均左心室射血分数 （LVEF） 分别为 19.2 ± 5.2%，7 例 （35%） 患者为 SCAI C 期，9 例 （45%） SCAI D 期，4 例 （20%） SCAI E 期，平均血管活性物质-正性肌力评分为 23.2 ± 38.0。Impella 支持的平均持续时间为 10.5 ± 8 天。在 180 天时，19 名 （95%） 患者存活，没有患者接受心脏移植/LVAD，40% 植入了 ICD，有 2 例因心力衰竭入院。平均 LVEF 为 33.5 ± 10.7%，5 例 （26.3%） 患者为 NYHA I 级，9 例 （47.4%） 为 NYHA II 级，5 例 （26.3%） 为 NYHA III 级。1 例患者死于非心脏原因。结论Impella 5+ 代表了一种很有前途的 CS 治疗策略，可提供高自体心脏的持续恢复率。机械和药物卸载的综合平台是关键。