• Curr Opin Crit Care · Aug 2024

    Review

    How preclinical models help to improve outcome in cardiogenic shock.

    • Alexander Moiroux-Sahraoui, Francesca Manicone, and Antoine Herpain.
    • Experimental Laboratory of Intensive Care, Université Libre de Bruxelles, Brussels, Belgium.
    • Curr Opin Crit Care. 2024 Aug 1; 30 (4): 333339333-339.

    Purpose Of ReviewPreclinical experimentation of cardiogenic shock resuscitation on large animal models represents a powerful tool to decipher its complexity and improve its poor outcome, when small animal models are lacking external validation, and clinical investigation are limited due to technical and ethical constraints. This review illustrates the currently available preclinical models addressing reliably the physiopathology and hemodynamic phenotype of cardiogenic shock, highlighting on the opposite questionable translation based on low severity acute myocardial infarction (AMI) models.Recent FindingsThree types of preclinical models replicate reliably AMI-related cardiogenic shock, either with coronary microembolization, coronary deoxygenated blood perfusion or double critical coronary sub-occlusion. These models overcame the pitfall of frequent periprocedural cardiac arrest and offer, to different extents, robust opportunities to investigate pharmacological and/or mechanical circulatory support therapeutic strategies, cardioprotective approaches improving heart recovery and mitigation of the systemic inflammatory reaction. They all came with their respective strengths and weaknesses, allowing the researcher to select the right preclinical model for the right clinical question.SummaryAMI-related cardiogenic shock preclinical models are now well established and should replace low severity AMI models. Technical and ethical constraints are not trivial, but this translational research is a key asset to build up meaningful future clinical investigations.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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