Exploring Gender-Specific Trends in Cardiac Index and Renal Function among Patients with Cardiogenic Shock Undergoing Axillary Mechanical Circulatory Support

9943 

Abstract Submission 

Shriya Sharma (1), Rohan Goswami (2), Jose Ruiz (2), Aarti Desai (2), Juan Leoni (2)

(1) Mayo Clinic in Florida, Jacksonville, Fl, (2) Mayo Clinic in Florida, Jacksonville, FL

Shriya Sharma    -  Contact Me
Mayo Clinic in Florida

Rohan Goswami    -  Contact Me
Mayo Clinic in Florida

Jose Ruiz    -  Contact Me
Mayo Clinic in Florida

Aarti Desai    -  Contact Me
Mayo Clinic in Florida

Juan Leoni    -  Contact Me
Mayo Clinic in Florida

Shriya Sharma    -  Contact Me
St Elizabeth's Medical Center

Objective:

To assess gender-based differences in hemodynamics and kidney outcomes at our center. Impella 5.5 devices are increasingly utilized in patients with cardiogenic shock (CS) to provide hemodynamic support, left ventricular unloading, and reduction in left ventricle end-diastolic pressure thereby lowering myocardial oxygen demand and improving end-organ perfusion.

Methods:

A retrospective cohort analysis of patients with CS at Mayo Clinic in Florida supported by Impella 5.5 between March 2019 and October 2021 was performed. Mann-Whitney U and paired t-test was performed with significance set at p < 0.05.

Results

The study investigated cardiovascular and renal parameters among a population of sixteen consecutive patients, equally stratified by gender. The mean age for females was 53 and 55 for males with BMI of 27.1 and 29.4 respectively. Females were found to have higher baseline MAP (86 vs. 74, p=0.007) and lower cardiac index of 1.65 L/min/m2 vs. 2.04 l/min/m2, p=.004. Post-device placement, PA pressures were markedly lower in females with PAs of 46 vs 53, p=.002 and Pad of 19 vs 24, p=.012. There was also a significant increase in post-Impella GFR in females compared to males, 79 vs 67, p=.004. All patients survived until heart transplantation while supported with the Impella 5.5 without the need for renal replacement therapies.

Conclusions:

These findings highlight significant gender differences in the outcomes of patients with cardiogenic shock when managed with temporary mechanical circulatory support. Further assessment in larger data sets should be utilized to determine the appropriateness of standardized criteria for all patients requiring advanced therapies.

Heart Transplant