Acute cardiac care & resuscitation

Right ventricular free-wall strain-based risk stratification for temporary mechanical circulatory support in cardiogenic shock

ESC Heart FailPublished single-centre retrospective study

Main finding · Temporary MCS implantationResult — go to the resultOdds ratio 10.49 95% CI 3.72–29.59

Authors' conclusion

Integration of RV FWLS with clinical parameters may improve early risk stratification in CS.

Study context

Population
Patients admitted with cardiogenic shock (CS) with transthoracic echocardiography within 24 h of CS diagnosis and prior to mechanical circulatory support (MCS) implantation, January 2023 to December 202531 (34%) required temporary MCS
Participants
Ninety-two patients
Exposure
Severe right ventricular (RV) FWLS impairment and temporary MCS use
Outcome
Temporary MCS implantation
Follow-up
During hospitalization

Main finding

Temporary MCS implantation

Odds ratio

10.49

95% CI 3.72–29.59

Severe RV FWLS impairment (<11%)
OR 10.49 (95% CI 3.72–29.59)

As reported in the abstract

Observational data: associations, not effects.

Secondary outcomes

Intensive care stay

Severe RV FWLS vs comparator, intensive care stay
21 vs 8 days
  • P = .003

Hospital stay

Severe RV FWLS vs comparator, hospital stay
25 vs 14 days
  • P = .003

Mortality

Severe RV FWLS not linked to mortality

Discrimination for temporary MCS

RV FWLS AUC
0.74
RV FWLS with left ventricular ejection fraction (LVEF) and Sequential Organ Failure Assessment (SOFA) score AUC
0.82

Classification and regression tree-derived algorithm (RV FWLS, SOFA score, LVEF)

Overall accuracy
78%
Specificity
95%

Original publication

Right ventricular free-wall strain-based risk stratification for temporary mechanical circulatory support in cardiogenic shock. ESC Heart Fail. Published 27 April 2026. doi:10.1093/eschf/xvag116

Summarised from the published abstract; every number is checked against it

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