Cardiogenic Shock Integrated PHenotyping for Event Reduction

Inclusion Criteria: * Age ≥ 18 and \< 75, men and women; * 1\) Systolic blood pressure (SBP) \< 90mmHg or mean arterial pressure (MAP) \< 60 mmHg, after an appropriate fluid challenge if there is no sign of overt fluid overload; OR 2) need of vasoactive agents to maintain SBP \> 90 mmHg or MAP \> 60 mmHg. * Reduced ejection fraction (left ventricle systolic function ≤35%). * Moreover, eligible patients have to fit at least ONE of the following criteria/items of overt hypoperfusion: altered state of consciousness; sweaty and cold skin; mixed venous oxygen saturation \< 60%; arterial lactates \> 2 mmol/L; oliguria \< 0.5 ml/Kg/h for at least 6 hours. * Eligible patients shouldn't have contraindications to heart replacement therapy (HRT). Exclusion Criteria: The participant will not be enrolled if ANY of the following criteria will be detected: * Cardiogenic shock symptoms beyond 6 hours. * Septic shock with evident septic focus. * Cardiogenic shock due to acute myocardial infarction. * Cardiogenic shock due to acute myocarditis. * Cardiogenic shock due to pulmonary thromboembolism. * Reiterating major arrhythmias: VT or VF or AF, with ventricular rate \> 160 bpm. * Severe aortic valve disease. * Obstructive hypertrophic cardiomyopathy or constrictive pericarditis or severe heart failure due to congenital heart disease * Severe peripheral vascular disease that contraindicates mechanical support insertion. * Cardiogenic shock secondary to either cardiac or non-cardiac surgery…