Heart failure decompensation with cardiogenic shock exhibits distinct sequential inflammatory profiles
Abstract Aims The inflammatory profile of cardiogenic shock (CS) after myocardial infarction affects outcomes; however, little is known about the impact of inflammatory changes in CS caused by acute decompensated heart failure (ADHF‐CS). We measured levels of inflammatory cytokines in patients with...
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| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-06-01
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| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.15217 |
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| Summary: | Abstract Aims The inflammatory profile of cardiogenic shock (CS) after myocardial infarction affects outcomes; however, little is known about the impact of inflammatory changes in CS caused by acute decompensated heart failure (ADHF‐CS). We measured levels of inflammatory cytokines in patients with ADHF‐CS admitted to a cardiac intensive care unit (CICU). Methods We identified patients admitted to our CICU with ADHF‐CS who had consented to having biospecimens stored. We identified two comparator groups of patients with HF seen as outpatients with stored biospecimens: firstly, those who had no history of decompensation and did not develop CS during follow‐up after sample acquisition (stable HF), and secondly, a group of patients who developed CS during follow‐up (pre‐CS). All samples underwent 48‐plex cytokine and white blood cell differential testing with the differences between groups analysed by comparing means. Results Eighty‐four ADHF‐CS patients were identified who had samples obtained at a median of 2 [inter‐quartile range (IQR) 0–7] days after CICU admission. Thirty‐six pre‐CS outpatients had samples taken 137 (IQR 41–258) days before admission with CS, and 338 stable HF control patients were included. Cytokine profiles differed between ADHF‐CS and stable HF. Patients with CS had higher pro‐inflammatory cytokine levels [including interleukin‐1 (IL‐1), interleukin‐6 (IL‐6) and interleukin‐8 (IL‐8)] and total white cell counts than stable HF patients. Analysis of the pre‐CS outpatient group suggested an intermediate stage in subacute transition to CS. Conclusions ADHF‐CS is characterized by high levels of pro‐inflammatory cytokines and total white count, compared with ambulatory HF. Decompensation from HF has two distinct inflammatory phases that may help identify outpatients at risk of CS. |
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| ISSN: | 2055-5822 |