Document Detail

Progressive nature of myocardial injury in selected patients with cardiogenic shock.
MedLine Citation:
PMID:  626124     Owner:  NLM     Status:  MEDLINE    
To determine whether the extensive myocardial injury associated with cardiogenic shock in some patients results from a progressive rather than a discrete massive insult, a study was made of 15 selected patients who had cardiogenic shock within 48 hours of admission, 5 patients with hypovolemic shock without myocardial infarction and 11 patients with myocardial infarction without shock. Peak plasma MB creatine kinase (CK) activity was significantly higher in the seven patients with cardiogenic shock associated with initial infarction (213 international units [IU]/liter) than in patients with shock and previous infarction (98 IU/liter) and in patients with uncomplicated myocardial infarction (125 IU/liter). A prolonged time to peak MB CK activity (averaging 26 hours) and a plateau of elevated MB CK activity were seen in patients with shock associated with initial infarction. Because shock itself did not slow the rate of apparent MB CK disappearance, results obtained suggest that cardiogenic shock associated with initial infarction in selected patients results from progressive myocardial damage underlying continuing release of MB CK into the circulation. The findings are compatible with the concept that, in these patients, cardiogenic shock reflects a vicious cycle of spreading myocardial injury, progressive compromise of cardiac function, exacerbation of ischemia and perpetuation of myocardial damage.
A L Gutovitz; B E Sobel; R Roberts
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American journal of cardiology     Volume:  41     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1978 Mar 
Date Detail:
Created Date:  1978-04-17     Completed Date:  1978-04-17     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  469-75     Citation Subset:  AIM; IM    
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MeSH Terms
Creatine Kinase / blood*
Isoenzymes / blood*
Middle Aged
Myocardial Infarction / blood*,  complications
Myocardium / enzymology,  pathology*
Shock / blood
Shock, Cardiogenic / blood*,  pathology
Time Factors
Reg. No./Substance:
0/Isoenzymes; EC Kinase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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