Cardiogenic shock is a very complex clinical condition that entails a reduction of blood flow in the most important organs of the human body due to a massive myocardial infarction. More than 50,000 patients are diagnosed this condition in Europe every year, and women and elderly patients have the worst prognosis. The last major breakthrough in this field was around 20 years ago, when it was shown that the prognosis could be improved by urgent reopening of the occluded coronary artery that causes the myocardial infarction and leads to the cardiogenic shock. However, despite several recent attempts to improve the survival of patients with this condition, no significant improvement in mortality has yet been achieved. Most patients with cardiogenic shock end up with multiple organ dysfunction syndrome, which has a mortality rate of around 50% during the first 30 days after its appearance.

The EURO SHOCK project funded by the European Union’s Horizon 2020 Research and Innovation programme is the first large-scale clinical trial to investigate the early application of extracorporeal membrane oxygenation (ECMO) to reduce mortality associated with cardiogenic shock. ECMO is a type of mechanical circulatory support with which deoxygenated blood is extracted from the patient’s veins, enriched with oxygen and administered directly to the arterial system, thus preserving the body’s critical organs during the most serious stage of the disease. In the European trial scheduled to begin on 1 February, patients will receive an immediate revascularisation to open the occluded artery (a stent angioplasty). If they give their informed consent, they will be randomised to receive either a standard treatment or the same treatment with the application of ECMO in the first few hours after the diagnosis of cardiogenic shock.

A team of researchers from the Universitat Politècnica de Catalunya · BarcelonaTech (UPC) and the August Pi i Sunyer Biomedical Research Institute (IDIBAPS) - Hospital Clínic de Barcelona are participating in the project with CardioSense, a cardiovascular monitor that provides an early diagnosis with more accurate results than the current ones in less than 60 seconds. The results can be transmitted from anywhere with cell phone coverage. This “heart watchman” patented by the UPC detects both the electrocardiogram (the conventional signal of the heart’s electrical activity) and the arterial pulse wave velocity (related to blood pressure and arterial elasticity) through sensors touched by the patient’s hands or feet. The sensors can be placed on cell phone cases, tablets, watch straps, scales, steering wheels, handlebars or any other object that can be touched with both the user’s hands or feet at once. This system, developed by researchers of the UPC’s Instrumentation, Sensors and Interfaces Group (ISI), headed by Ramon Pallàs, can be incorporated into other devices that use similar sensors, such as body mass analysers, which use electric pulses between the hands to measure body fat. They can also be incorporated in scales (including those found in chemist’s shops).

Within the framework of the EURO SHOCK project, the UPC will develop a telecardiology monitor for tracking the patients after discharge in order to reduce hospital visits. With CardioSense technology, any family member or assistant can apply the device to the patient at home without specific training.

The participants in the EURO SHOCK project, led by researcher Anthony Gershlick of the University of Leicester, include 12 leading university hospitals from nine European countries. The remaining project partners are accelopment AG (Switzerland), Azienda Ospedaliera Papa Giovanni XXIII (Italy), Chalice Medical Limited (United Kingdom), Deutsches Herzzentrum München (Germany), the University of Glasgow (United Kingdom), the Katholieke Universiteit Leuven (Belgium), the Ludwig-Maximilians Universität München (Germany), the Paula Stradina Kliniska Universitates Slimnica (Latvia), the University of East Anglia (United Kingdom), the Universitetet i Tromsø (Norway) and the Universitair Ziekenhuis Antwerpen (Belgium).

Further information

• UPC patents system for cardiovascular pre-diagnosis—in under a minute—based on contact with user’s hands or feet elit