Acute myocardial infarction-related cardiogenic shock (AMI-CS) is commonly clinically characterised by low blood pressure. Noradrenaline is the guideline-recommended first-line vasopressor therapy in patients in cardiogenic shock to increase blood pressure. Although no strict criteria exist, noradrenaline is commonly titrated to a mean arterial pressure (MAP) of above 65 mmHg. No evidence exists, however, that targeting a pharmacologically induced MAP of above 65 mmHg improves clinical outcome. Furthermore, noradrenaline is associated with unwanted effects such as elevated afterload, increased myocardial oxygen demand, and arrhythmias. Therefore, we sought to investigate whether treatment with a lower noradrenaline-mediated MAP-target regimen in AMI-CS patients leads to improved outcomes. In this international, open-label, multicentre, randomised superiority trial, 776 patients will be allocated in a 1:1 ratio to either the index treatment of a lower noradrenaline-mediated MAP-target regimen (MAP of 55 mmHg) or a standard noradrenaline-mediated MAP-target regimen (MAP of at least 65 mmHg). The NORshock trial tests the hypothesis that a permissive hypotension treatment strategy with reduced use of noradrenaline in patients with AMI-CS is superior to standard care in terms of a combined endpoint of all-cause death and renal replacement therapy within 30 days. The NORshock trial is the first randomised trial investigating a strategy of a lower noradrenaline-mediated MAP-target regimen (MAP of 55 mmHg) compared with a standard noradrenaline-mediated MAP-target regimen (MAP of at least 65 mmHg) on clinical outcomes in AMI-CS patients.

Left atrial appendage closure (LAAC) is an established alternative for stroke prevention in patients with non-valvular atrial fibrillation who are not suitable candidates for long-term oral anticoagulation. Imaging is central to procedural success and safety, yet variability in acquisition, measurement, and reporting contributes to inconsistent workflows and outcomes among centres. This expert consensus document from the European Left Atrial Appendage Closure Club provides a unified framework for pre-, intra-, and postprocedural imaging in LAAC with the aim of reducing variability, standardising workflows, and improving clinical reproducibility. The consensus emphasises high-quality image acquisition, reproducible measurements, and the prioritisation of three-dimensional (3D) imaging techniques and multiplanar reconstruction. Standardised terminology, core anatomical parameters, and device-oriented requirements are defined to support consistent procedural planning and device selection. Intraprocedural recommendations focus on real-time guidance using 3D transoesophageal echocardiography, intracardiac echocardiography, and fusion imaging for transseptal puncture, device alignment, deployment, and sealing assessment. Postprocedural guidance harmonises echocardiographic and cardiac computed tomography criteria and proposes structured follow-up pathways for the assessment of device-related thrombus, peridevice leak, and device stability. By promoting consistent nomenclature and structured, evidence-informed imaging strategies across the entire LAAC pathway, this consensus aims to enhance procedural safety, improve reproducibility, and support uniform, high-quality LAAC practice across centres.