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Organ Perfusion in Acute Heart Failure Syndromes

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Acute Heart Failure

Abstract

Acute heart failure syndromes (AHFSs) are associated with some degree of perfusion abnormality that is not necessarily evident. Cardiogenic shock is among the most important manifestations of the AHFS and is defined by clinically obvious or measured inadequate end-organ perfusion and tissue hypoxia with mortality in the range of 50%1. Causes of death are not only cardiogenic shock but also various organ failures despite normalized cardiac index2. Renal dysfunction, for example, is the most frequent and apparent organ dysfunction and is a powerful adverse prognostic factor (reviewed in Gheorghiade et al.3). Low organ perfusion during AHFS (Fig. 15.1) may result from a “forward” failure (acute coronary syndrome, myocardial failure with cardiogenic shock of various etiologies), from a “backward” failure with congestion due to global or right heart failure, or from a maladapted peripheral vasoconstriction (hypertensive acute heart failure). Regional redistribution of blood flow toward various vascular beds in the setting of AHFS has been seldom addressed over the last three decades compared to other acute states such as sepsis or hemorrhage, and consequently this chapter focuses on low-output AHFS.

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Author information

Authors and Affiliations

  1. Department of Internal Medicine, Jewish General Hospital, McGill University, Montreal, QC, Canada

    Tal H. Kopel MD

  2. Anaesthesia and Critical Medicine, Lariboisière University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Diderot, Paris, France

    Marie-Reine Losser MD, PhD

Authors
  1. Tal H. Kopel MD
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  2. Marie-Reine Losser MD, PhD
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Editors and Affiliations

  1. Department of Anesthesiology and Critical Care Medicine, Lariboisière University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Diderot, Paris, France

    Alexandre Mebazaa MD, PhD (Professor of Medicine) (Professor of Medicine)

  2. Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Mihai Gheorghiade MD, FACC (Professor of Medicine and Surgery, Associate Chief, Division of Cardiology and Chief, Cardiology Clinical Service) (Professor of Medicine and Surgery, Associate Chief, Division of Cardiology and Chief, Cardiology Clinical Service)

  3. Department of Cardiology Centre d’Investigation Clinique (CIC), INSERM U-684, Centre Hospitalier Universitaire, University Henri Poincaré, Nancy, France

    Faiez M. Zannad MD, PhD, FESC (Professor of Medicine) (Professor of Medicine)

  4. Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, Camden, NJ, USA

    Joseph E. Parrillo MD (Professor of Medicine, Chief, Department of Medicine Edward D. Viner MD Chair, Department of Medicine and Director) (Professor of Medicine, Chief, Department of Medicine Edward D. Viner MD Chair, Department of Medicine and Director)

  5. Cooper Heart Institute, Cooper University Hospital, Camden, NJ, USA

    Joseph E. Parrillo MD (Professor of Medicine, Chief, Department of Medicine Edward D. Viner MD Chair, Department of Medicine and Director) (Professor of Medicine, Chief, Department of Medicine Edward D. Viner MD Chair, Department of Medicine and Director)

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Kopel, T.H., Losser, MR. (2008). Organ Perfusion in Acute Heart Failure Syndromes. In: Mebazaa, A., Gheorghiade, M., Zannad, F.M., Parrillo, J.E. (eds) Acute Heart Failure. Springer, London. https://doi.org/10.1007/978-1-84628-782-4_15

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  • DOI: https://doi.org/10.1007/978-1-84628-782-4_15

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84628-781-7

  • Online ISBN: 978-1-84628-782-4

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