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Acute cardiac care & resuscitationCohort study

Cardiac mechanical efficiency in patients with cardiogenic shock

Eur Heart J Acute Cardiovasc CarePublished

  • retrospective cohort study
  • consecutive adults
  • single cardiac intensive care unit (Mayo Clinic)
Read the original article ↗

Authors' conclusion

Early TTE-derived mCE was independently associated with short- and long-term mortality in CS, particularly in acute coronary syndrome-related CS, and captured the interaction between ventricular remodelling and mechanical performance underlying high-risk phenotypes.

Study context

Population
Consecutive adults admitted with cardiogenic shock (CS) to the cardiac intensive care unit at Mayo Clinic (2007–2018) with TTE performed within 24 hpatients included
Participants
667 adults
Exposure
Modified cardiac efficiency (mCE) quartiles vs lowest quartile
Outcome
In-hospital mortality
Follow-up
In-hospital

Main finding

As reported in the abstract

Odds ratio

2.53

95% CI 1.49–4.37

P < 0.001

lowest quartile
OR 2.53 (95% CI 1.49–4.37); P < 0.001
In-hospital mortality
28%

Observational data: associations, not effects.

Secondary outcomes

1-year mortality (secondary outcome)

ComparisonHR (95% CI)P value
lowest quartile · adjusted hazard of death; higher in lowest quartile · multivariable Cox model2.05 (1.45–2.89)P < 0.001
1-year mortality (secondary outcome) — One-year mortality
41%

mCE (descriptive)

median mCE
48 mmHg (IQR 32-74)

Effect modification by shock aetiology (acute coronary syndrome-related CS)

Associations stronger in acute coronary syndrome-related CS
  • interaction P = 0.035 for in-hospital
  • interaction P = 0.015 for 1-year

Systolic pressure within the lowest quartile

Within the lowest quartile, reduced systolic pressure further amplified mortality risk

Original publication

Cardiac mechanical efficiency in patients with cardiogenic shock. Eur Heart J Acute Cardiovasc Care. Published 22 July 2026. doi:10.1093/ehjacc/zuag098
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Summarised from the published abstract; every number is checked against it