Multi-Center, Multi-Society Study of Impella-supported Patients with Cardiogenic Shock due to Myocarditis in Japan Achieves 30-day Survival of 77%

2022-09-21

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The analysis examined 143 consecutive patients with cardiogenic shock due to myocarditis who received Impella support or Impella plus VA ECMO support, known as ECpella This heart pump is designed for long-duration support, enables patient mobility and optimizes recovery by using real-time intelligence. (Credit: Kenny Eliason on Unsplash) Abiomed (ABMD) announces the result of a three-year, investigator-led study of all Impella-supported patients treated at 109 hospitals in Japan shows a 30-day survival rate of 77% for patients with cardiogenic shock due to myocarditis. This study is an update to a 2020 interim analysis and was announced at the 2022 Transcatheter Cardiovascular Therapeutics (TCT) conference in Boston. The analysis examined 143 consecutive patients with cardiogenic shock due to myocarditis who received Impella support or Impella plus VA ECMO support, known as ECpella. These patients are included in the J-PVAD registry, a registry conducted by 10 Japanese professional societies, including the Japanese Circulation Society (JCS). The results demonstrated a 77% survival at 30 days for these patients. A previous analysis of myocarditis patients who only received VA ECMO support found 48% survival at 30 days (Journal of Heart and Lung Transplantation, 2021). “These findings further demonstrate the potential of increasing native heart recovery in myocarditis patients through the use of Impella, which is an important consideration given the limited number of heart transplants,” said lead investigator Koichi Toda, MD, a cardiovascular surgeon at the department of cardiovascular surgery at Osaka University Graduate School of Medicine. Myocarditis is the inflammation of the heart muscle often caused by a viral infection. This inflammation may affect the heart’s electrical system and cause the muscle to enlarge, which has the potential to weaken the heart and force it to work harder to circulate blood and oxygen to the rest of the body. Ultimately, this could lead to heart failure. According to a U.S. Centers for Disease Control and Prevention (CDC) report, rates of myocarditis have increased since the start of the COVID-19 pandemic to approximately 146 cases per 100,000 people, up from <10 cases per 100,000 people. The same report also showed that patients with COVID-19 had close to 16 times the risk for developing myocarditis compared to patients who did not have COVID-19. “Myocarditis is a growing epidemic in the COVID-19 era. It is exciting to see data from this study demonstrates the potential for Impella support to improve patient outcomes in this very sick patient population,” said Masahiro Ono, MD, a cardiovascular surgeon at Methodist Healthcare in San Antonio, Texas. In Aug. 2020, the U.S. FDA issued an emergency use authorization (EUA) for left-sided Impella heart pumps to provide left ventricular unloading and support to COVID-19 patients who are undergoing ECMO treatment and develop pulmonary edema or myocarditis. In January 2022, 31-year-old Bobby Goines, a husband, father of three and sales representative from Conway, AR, was diagnosed with myocarditis due to COVID-19 and was in cardiogenic shock. At CHI St. Vincent, Dr. Thurston Bauer implanted Impella 5.5 with SmartAssist to support Bobby’s heart and allow it to rest. After eight days of support, during which Bobby was able to walk around the unit and his condition improved, Impella was weaned and removed. Bobby returned home with normal heart function and is now back to work and enjoying time with his family. Source: Company Press Release

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