Evidence map›Paper›PMID 41043939›Full record

ArticleJACC. Advances2025

Association Between Pressure-Adjusted Heart Rate and In-Hospital Mortality in Cardiogenic Shock.

Curtis R Ginder, Jacob C Jentzer, Siddharth M Patel, Erin A Bohula, Carlos E Alfonso, Christopher F Barnett, Gregory W Barsness, Mark W Dodson, Shahab Ghafghazi, Umesh Gidwani and 10 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. Advances, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Curtis R GinderLevine Cardiac Intensive Care Unit, TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Jacob C JentzerDivision of Critical Care Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Siddharth M PatelLevine Cardiac Intensive Care Unit, TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Erin A BohulaLevine Cardiac Intensive Care Unit, TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Carlos E AlfonsoDivision of Cardiology, Department of Medicine, University of Miami School of Medicine, Miami, Florida, USA.
Christopher F BarnettDivision of Cardiology, Department of Medicine, University of California-San Francisco, San Francisco, California, USA.
Gregory W BarsnessDivision of Critical Care Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Mark W DodsonDepartment of Pulmonary and Critical Care Medicine, Intermountain Medical Center, Murray, Utah, USA.
Shahab GhafghaziDivision of Cardiovascular Medicine, Department of Medicine, University of Louisville, Louisville, Kentucky, USA.
Umesh GidwaniDivision of Cardiology, Mount Sinai, New York, New York, USA.
Jianping GuoLevine Cardiac Intensive Care Unit, TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Younghoon KwonDivision of Cardiology, University of Washington, Seattle, Washington, USA.
Shuangbo LiuSection of Cardiology, Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Venu MenonDepartment of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Sarah A MorrowLevine Cardiac Intensive Care Unit, TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Connor G O'BrienDivision of Cardiology, Department of Medicine, University of California-San Francisco, San Francisco, California, USA.
Brian J PotterCentre Hospitalier de l'Université de Montréal Research Center and Cardiovascular Center, Montreal, Quebec, Canada.
Jason N KatzDivision of Cardiology, New York University Grossman School of Medicine & Bellevue Hospital, New York, New York, USA.
Sean van DiepenDepartment of Critical Care Medicine and Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
David D BergLevine Cardiac Intensive Care Unit, TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA. Electronic address: dberg1@bwh.harvard.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAmong patients with cardiogenic shock (CS), higher right atrial pressure (RAP) and lower mean arterial pressure (MAP) are associated with higher in-hospital mortality. Pressure-adjusted heart rate (PAHR), defined as heart rate × RAP/MAP, integrates these parameters. The prognostic significance of PAHR has not been assessed in patients with CS.

objectivesThe authors aimed to assess if PAHR values are associated with risk of in-hospital mortality in patients with CS.

methodsCCCTN (Critical Care Cardiology Trials Network) is a multinational registry of cardiac intensive care units coordinated by the TIMI Study Group. Among CS admissions (2018-2023) undergoing invasive hemodynamic assessment within 24 hours of cardiac intensive care unit admission, we assessed the relationship of PAHR with in-hospital mortality. Patients with concurrent mechanical circulatory support were excluded in the primary analysis. ORs were adjusted for age, sex, vasoactive-inotropic score, Society for Cardiovascular Angiography and Interventions (SCAI) stage, and preceding cardiac arrest.

resultsAmong the 1411 CS admissions in the analysis (18% with acute myocardial infarction), 75% were receiving vasoactive support at the time of assessment. Median heart rate was 92 beats/min, RAP 15 mm Hg, MAP 75 mm Hg, and PAHR 17. There was a stepwise gradient of higher in-hospital mortality with higher presenting PAHR values. In adjusted models, a higher PAHR was incrementally associated with higher in-hospital mortality (adjusted OR per 10 units: 1.35 [95% CI: 1.15-1.58]), and PAHR had stronger prognostic associations with mortality than its individual hemodynamic components.

conclusionsPAHR, a simple hemodynamic index calculated from vital signs and central venous pressure, is strongly associated with in-hospital mortality in CS.

Indexed as

cardiac intensive care unitcardiogenic shockinvasive hemodynamicspressure-adjusted heart raterisk stratification

Identifiers

PMID41043939
PMCPMC12541222

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.