| Abstract [eng] |
Cardiogenic shock remains one of the leading causes of mortality in critically ill cardiac patients, and its various haemodynamic manifestations complicate diagnosis and treatment. Accurate analysis of haemodynamic profiles is essential for the correct classification of shock and the timely application of targeted interventions. Despite advances, current treatments often follow a uniform pattern that may not meet the needs of different shock phenotypes. The aim of this literature review is to analyse and summarise the current scientific evidence on haemodynamic profiles in cardiogenic shock and to assess their impact on clinical decision-making, with the aim of highlighting the importance of individualised assessment for more effective and targeted treatment. Objectives: 1. Evaluate the role of haemodynamic monitoring in identifying different phenotypes of cardiogenic shock. 2. Identify the main phenotypes of cardiogenic shock and their implications for treatment strategies and prognosis. 3. Evaluate the efficacy of current treatment approaches tailored to different phenotypes of cardiogenic shock. Methods: literature search was performed using PubMed and Google Scholar databases. The following keywords were used to search the literature: “cardiogenic shock”, “heart failure”, “acute myocardial infarction”, “haemodynamic monitoring”, “phenotyping”, “classification”, “SCAI stages”, “pulmonary artery catheter”, “management”, “vasopressors”, “inotropes”, “mechanical circulatory support”, “coronary artery revascularization”, “risk stratification”. Only studies that are fully accessible and written in English were selected. The 70 articles that are selected were published between 1999 and 2025. Results: cardiogenic shock is a clinically and haemodynamically heterogeneous condition and standardised treatment is often ineffective. Phenotyping allows a better understanding of the underlying pathophysiological mechanisms and more targeted treatment. Haemodynamic monitoring, using both invasive and non-invasive tools, is essential for real-time personalised decision-making. In the future, advanced markers and artificial intelligence will allow further personalisation of cardiogenic shock treatment, improving patient survival. Conclusions: 1. Haemodynamic monitoring using tools such as pulmonary artery catheters, central venous catheters or less invasive devices is essential to identify different phenotypes of cardiogenic shock by monitoring various haemodynamic parameters. This helps to make more accurate treatment decisions. 2. The phenotypes of cardiogenic shock can be divided into classical phenotypes based on tissue perfusion and fluid volume; which ventricle is predominant in cardiogenic shock; and the most recent phenotypes - non-congestive, cardiorenal, cardiometabolic. The haemodynamic phenotype allows to predict the patient's risk, to anticipate the possible course of the disease and to make decisions on treatment tactics. 3. Individualised treatment based on cardiogenic shock phenotypes allows more precise targeting of therapy to the underlying pathophysiological mechanisms, leading to more effective treatment and better clinical outcomes. Keywords: „cardiogenic shock“, „acute myocardial infarction“, „hemodynamic monitoring“, „phenotyping“, „pulmonary artery catheter“, „management“. |
