Cardiogenic shock Circulatory System Cardiogenic shock
Conditions
Interventions
HERACLES is a randomised control trial designed to compare the physiological effects on myocardial oxygen supply and demand of ventricular unloading with either an IABP or Impella in patients supporte
Sponsors
King's College London
Eligibility
Sex/Gender
All
Age
18 Years to 110 Years
Inclusion criteria
Inclusion criteria: 1. Patients aged =18 years with cardiogenic shock of any aetiology 2. On veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support or starting VA-ECMO post PCI 3. Undergoing clinically indicated cardiac catheterisation
Exclusion criteria
Exclusion criteria: 1. Post-cardiotomy cardiogenic shock 2. Confirmed left ventricular thrombus on imaging 3. Age <18 years 4. Pregnancy or peripartum cardiomyopathy 5. Contraindication to either intra-aortic balloon pump (IABP) or percutaneous left ventricular assist device (pLVAD) insertion i.e. =moderate aortic regurgitation (AR), severe peripheral vascular disease (PVD) prohibiting insertion of either device 6. Mechanical aortic valve replacement (AVR)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Coronary device flow reserve measured using a coronary guidewire post left ventricular (LV) unloading | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Early effect of LV unloading measured using an LV catheter post LV unloading 2. Minimal microvascular resistance calculated from pressure and flow measurements post LV unloading 3. Time to VA-ECMO decannulation (days) measured using patients' medical records 4. Days alive and off ICU (at 30 days post randomisation) measured using patients' medical records | — |
Countries
United Kingdom
Outcome results
None listed