Clinical Associations of Successful Weaning from Impella Support in Non-ischemic Cardiogenic Shock
Abstract
Background The efficacy of Impella in ischemic cardiogenic shock (CS) has been examined. This study evaluated the Impella clinical course in non-ischemic CS and examined the differences in 72-h factors after Impella implantation between successful and unsuccessful weaning. Methods This observational, retrospective, single-center cohort study included 43 patients with non-ischemic CS [fulminant myocarditis (n=25) and HF-related CS (n=18)] from July 2018 to July 2022. The background, clinical course, and clinical predictors of successful weaning were evaluated in this study. Results The median age was 45 (31-53) years; 37% (n=16) were women, 79% (n=34) were on concomitant veno-arterial extracorporeal membrane oxygenation. duration of Impella use was 11 (6-20) days; 14% (n=6) had severe bleeding, 26% (n=11) had bacteremia complications, and 53% (n=24) required new temporary dialysis. The 30-day unsuccessful Impella weaning rates for HF-related CS and fulminant myocarditis were 36% and 33%; the 365-day rates were 48% and 67%, respectively. Regarding the factors between successful and unsuccessful Impella weaning, left ventricular ejection fraction and serum lactate dehydrogenase levels significantly differed 72 h after Impella implantation in fulminant myocarditis and with systolic blood pressure in HF-related CS. Conclusion In non-ischemic CS cases requiring Impella, successful weaning rates vary greatly depending on the underlying disease, and the factor at 72h after Impella insertion are associated with the subsequent course.
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BibTeX
@article{koyama2026clinical,
title = {{Clinical Associations of Successful Weaning from Impella Support in Non-ischemic Cardiogenic Shock}},
author = {Yuichiro Koyama and Ryota Morimoto and Shin Nagai and Asuka Nozaki and Chiaki Mizuno and Ryota Ito and Kiyota Kondo and Shotaro Komeyama and Yusuke Fujikawa and Shingo Kazama and Hiroaki Hiraiwa and Toru Kondo and Toyoaki Murohara},
journal = {Internal Medicine},
year = {2026},
month = jul,
doi = {10.2169/internalmedicine.7329-26},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7329-26/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Clinical Associations of Successful Weaning from Impella Support in Non-ischemic Cardiogenic Shock
AU - Yuichiro Koyama
AU - Ryota Morimoto
AU - Shin Nagai
AU - Asuka Nozaki
AU - Chiaki Mizuno
AU - Ryota Ito
AU - Kiyota Kondo
AU - Shotaro Komeyama
AU - Yusuke Fujikawa
AU - Shingo Kazama
AU - Hiroaki Hiraiwa
AU - Toru Kondo
AU - Toyoaki Murohara
PY - 2026
DA - 2026/07/25
JO - Internal Medicine
DO - 10.2169/internalmedicine.7329-26
UR - https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7329-26/_article
AB - Background The efficacy of Impella in ischemic cardiogenic shock (CS) has been examined. This study evaluated the Impella clinical course in non-ischemic CS and examined the differences in 72-h factors after Impella implantation between successful and unsuccessful weaning. Methods This observational, retrospective, single-center cohort study included 43 patients with non-ischemic CS [fulminant myocarditis (n=25) and HF-related CS (n=18)] from July 2018 to July 2022. The background, clinical course, and clinical predictors of successful weaning were evaluated in this study. Results The median age was 45 (31-53) years; 37% (n=16) were women, 79% (n=34) were on concomitant veno-arterial extracorporeal membrane oxygenation. duration of Impella use was 11 (6-20) days; 14% (n=6) had severe bleeding, 26% (n=11) had bacteremia complications, and 53% (n=24) required new temporary dialysis. The 30-day unsuccessful Impella weaning rates for HF-related CS and fulminant myocarditis were 36% and 33%; the 365-day rates were 48% and 67%, respectively. Regarding the factors between successful and unsuccessful Impella weaning, left ventricular ejection fraction and serum lactate dehydrogenase levels significantly differed 72 h after Impella implantation in fulminant myocarditis and with systolic blood pressure in HF-related CS. Conclusion In non-ischemic CS cases requiring Impella, successful weaning rates vary greatly depending on the underlying disease, and the factor at 72h after Impella insertion are associated with the subsequent course.
SN - 1349-7235
SN - 0918-2918
ER -