Current Clinical Treatments and Challenges for Heart Failure and Cardiogenic Shock

Dear Colleagues,

Background: Heart failure and cardiogenic shock continue to be associated with significant morbidity and mortality, with a wide spectrum of etiologies and each patient presenting with peculiar characteristics. While current therapies for chronic heart failure are numerous and supported by strong and growing bodies of evidence, the best treatment strategy for patiens suffering from cardiogenic shock remains to be defined. Importantly, the intersection between the acute phase and the opportunity to start guideline-directed medical therapy has not yet been reported. Inotropes are often use in clinical practice, but no impact on outcomes has been demonstrated. Moreover, their cardiocirculatory effects, when prolonged, may be deleterious. By contrast, early MCS may reduce the need of inotropes/vasopressors; however, the best available evidence on the medical treatment of heart failure is not acknowledged in cardiogenic shock. MCS use has risen dramatically, with Impella CP having recently been shown to be superior to standard therapy, but catecholamine use is still very widespread. Goals: The aim of this work is to focus on contemporary drug management in the clinical scenario of cardiogenic shock, acknowledging the evidence from RCTs and leveraging that on GDMT to further improve the outcomes of patients with severe heart failure. We also aim to provide information on the potential for native heart recovery and its associated benefits, as well as discuss the new frontiers of heart replacement with a totally artificial heart and its role in very sick patients.

Information to Authors: Led by an interdisciplinary team of experts, this Special Issue is open for submissions of original articles, reviews, and viewpoints focused on MCS and cardiogenic shock, with a specific focus on patients with heart failure. The areas of interest include but are not limited to the following: (1) hemodynamic adaptations after MCS; (2) identification of biventricular failure; (3) PCI strategies in MCS-supported patients with CS; and (4) perioperative optimization of high-risk patient candidates for heart replacement therapies.

Dr. Andrea Montisci
Prof. Dr. Federico Pappalardo
Guest Editors

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• cardiogenic shock
• heart failure
• mechanical circulatory support
• Impella
• veno-arterial ECMO
• unloading
• heart failure
• heart transplant
• artificial heart
• left ventricular assist devices