A1 Refereed original research article in a scientific journal

Mechanical circulatory support for cardiogenic shock in takotsubo syndrome



Authors: Cammann, Victoria L.; Schweiger, Victor; Szawan, Konrad A.; Di Vece, Davide; Niederseer, David; Würdinger, Michael; Schönberger, Alexander; Schönberger, Maximilian; Koleva, Iva; Mercier, Julien C.; Citro, Rodolfo; Vecchione, Carmine; Bossone, Eduardo; Gili, Sebastiano; Neuhaus, Michael; Franke, Jennifer; Meder, Benjamin; Jaguszewski, Miłosz; Noutsias, Michel; Knorr, Maike; Jansen, Thomas; D’Ascenzo, Fabrizio; Dichtl, Wolfgang; von Lewinski, Dirk; Burgdorf, Christof; Kherad, Behrouz; Elsanhoury, Ahmed; Tschöpe, Carsten; Nelki, Vivian Alice; Sarcon, Annahita; Shinbane, Jerold; Rajan, Lawrence; Michels, Guido; Pfister, Roman; Cuneo, Alessandro; Jacobshagen, Claudius; Karakas, Mahir; Koenig, Wolfgang; Pott, Alexander; Meyer, Philippe; Roffi, Marco; Banning, Adrian; Wolfrum, Mathias; Cuculi, Florim; Kobza, Richard; Fischer, Thomas A.; Vasankari, Tuija; Airaksinen, K. E. Juhani; Napp, L. Christian; Dworakowski, Rafal; MacCarthy, Philip; Kaiser, Christoph; Osswald, Stefan; Galiuto, Leonarda; Chan, Christina; Bridgman, Paul; Beug, Daniel; Felix, Stephan B.; Delmas, Clément; Lairez, Olivier; Gilyarova, Ekaterina; Shilova, Alexandra; Gilyarov, Mikhail; El-Battrawy, Ibrahim; Akin, Ibrahim; Poledniková, Karolina; Toušek, Petr; Winchester, David E.; Massoomi, Michael; Galuszka, Jan; Ukena, Christian; Poglajen, Gregor; Carrilho-Ferreira, Pedro; Hauck, Christian; Paolini, Carla; Bilato, Claudio; Kobayashi, Yoshio; Kato, Ken; Ishibashi, Iwao; Himi, Toshiharu; Din, Jehangir; Al-Shammari, Ali; Prasad, Abhiram; Rihal, Charanjit S.; Liu, Kan; Schulze, P. Christian; Bianco, Matteo; Jörg, Lucas; Rickli, Hans; Pestana, Gonçalo; Nguyen, Thanh H.; Böhm, Michael; Maier, Lars S.; Pinto, Fausto J.; Widimský, Petr; Braun-Dullaeus, Ruediger C.; Rottbauer, Wolfgang; Hasenfuß, Gerd; Pieske, Burkert M.; Schunkert, Heribert; Budnik, Monika; Opolski, Grzegorz; Thiele, Holger; Bauersachs, Johann; Horowitz, John D.; Di Mario, Carlo; Kong, William; Dalakoti, Mayank; Imori, Yoichi; Wehling, Laura; Mangner, Norman; Gerk, Ulrich; Münzel, Thomas; Crea, Filippo; Lüscher, Thomas F.; Bax, Jeroen J.; Seifert, Burkhardt; Ghadri, Jelena R.; Templin, Christian

Publisher: Springer Nature

Publication year: 2026

Journal: Clinical Research in Cardiology

ISSN: 1861-0684

eISSN: 1861-0692

DOI: https://doi.org/10.1007/s00392-025-02832-z

Publication's open availability at the time of reporting: Open Access

Publication channel's open availability : Partially Open Access publication channel

Web address : https://doi.org/10.1007/s00392-025-02832-z

Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/515599775

Self-archived copy's licence: CC BY

Self-archived copy's version: Publisher`s PDF


Abstract
Background

Cardiogenic shock complicates takotsubo syndrome (TTS) in approximately 10% of cases. The effectiveness of mechanical circulatory support (MCS) for managing cardiogenic shock in TTS remains unknown.

Methods

We assessed outcomes in TTS patients with cardiogenic shock who received MCS compared to medical therapy only by using data from the International Takotsubo Registry. Two independent propensity scores were computed to investigate outcomes of patients with an intra-aortic balloon pump (IABP) vs. medical therapy only (1:2 propensity score matched cohort) and patients with an Impella vs. medical therapy only (1:1 propensity score matched cohort). The primary endpoint was in-hospital mortality and the secondary outcomes included MCS-related complications.

Results

Among 3740 eligible patients, 309 (8.3%) patients had cardiogenic shock, of whom 112 (36.2%) had MCS and 197 (63.8%) had medical therapy only. After propensity-score matching, the use of an IABP was found to be associated with a lower in-hospital mortality rate than medical therapy only (14.5% vs. 35.5%, P = 0.002), while mortality rates in the Impella group and medical therapy only group were comparable (25.0% vs. 29.2%, P = 0.75). MCS-related complications occurred in 6.0% of the IABP cohort and in 31.3% of Impella cohort.

Conclusion

Active MCS has been increasingly used for the management of cardiogenic shock in patients with TTS. This observational study could not demonstrate an association with improved mortality with an Impella device, but possibly with an IABP when compared to patients with medical management only. MCS-related complications occurred more frequently in the Impella cohort than in the IABP cohort. Further data are required to confirm results of the present study.


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Funding information in the publication: 
Open Access funding enabled and organized by Projekt DEAL. The InterTAK Registry is supported by the Biss Davies Charitable Trust.


Last updated on 24/02/2026 04:14:16 PM