Marco M R, Aguilar L R, O'Callaghan A C, Jordá C F, Garcia R C, Mañez V P
Arch Mal Coeur Vaiss. 1979 Feb;72(2):130-8.
Of 698 cases of acute myocardial infarction (AMI), 65 cases of cardiogenic shock underwent haemodynamic study. 25 cases had pulmonary capillary pressures (PCP) less than 14 mmHg, 15 of which responded favourably to vascular filling. None of these cases died in a state of shock. In comparison with cardiogenic shock with PCP equal to or greater than 14 mmHg, these 25 patients showed the following features: 1) electrocardiography usually showed posterior or inferior infarction; 2) a higher incidence of right ventricular (RV) involvement; 3) left ventricular (LV) function was relatively unaffected; 4) haemodynamic criteria of RV infarction were demonstrated in most cases. In the absence of causes of hypovolaemia, AMI involving mainly the RV may lead to circulatory failure with normal LV filling pressures and responds favourably to vascular filling. When diagnosed and treated correctly this form of cardiogenic shock has a much lower mortality than usually associated with cardiogenic shock caused by AMI (28 p. 100 compared to 87.5 p. 100 in our series).
在698例急性心肌梗死（AMI）患者中，对65例心源性休克患者进行了血流动力学研究。25例患者的肺毛细血管压（PCP）低于14 mmHg，其中15例对血管补液反应良好。这些患者均未死于休克状态。与PCP等于或高于14 mmHg的心源性休克患者相比，这25例患者具有以下特征：1）心电图通常显示后壁或下壁梗死；2）右心室（RV）受累的发生率较高；3）左心室（LV）功能相对未受影响；4）大多数病例显示有RV梗死的血流动力学标准。在没有血容量不足原因的情况下，主要累及RV的AMI可能导致LV充盈压正常的循环衰竭，并对血管补液反应良好。正确诊断和治疗后，这种类型的心源性休克的死亡率远低于通常与AMI所致心源性休克相关的死亡率（我们系列研究中分别为28%和87.5%）。
