Nine patients with medically refractory decompensated heart failure-associated cardiogenic shock underwent Impella 5.5 placement with invasive biventricular pressure-volume assessment. Acutely after activation, cardiac output increased from 3.4 ± 0.5 to 5.0 ± 0.7 L/min versus baseline (p = 0.0011). Left ventricular end-diastolic pressure decreased from 24.1 ± 6.7 to 16.8 ± 5.4 mm Hg (p = 0.0027), alongside reductions in end-diastolic volume and pressure-volume area. Right ventricular end-diastolic and end-systolic pressures and pressure-volume area also decreased, suggesting acute biventricular physiological effects of left ventricular unloading.
This small study documents acute haemodynamic changes after Impella 5.5 activation in refractory heart failure-associated shock. These physiological findings do not establish patient-centred benefit.
Study limitation: Only nine patients were studied using acute before-and-after measurements, without a separate control group or reported patient-centred outcomes.
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