172 
CARDIAC MODELS 
RESULTS 
Clinical 
Table I summarizes the clinical observations 
in the 79 patients which included 53 men and 
26 women. The overall mean age was 59 years 
(29-83). The ratio of infarction location (an- 
terior to inferior) was 27/15 and 20/12 for 
Groups A and B, respectively. Transmural and 
subendocardial infarctions were grouped to- 
gether according to anterior or inferior posi- 
tion. Only five patients had left bundle branch 
block. Forty percent or more of all patients in 
Group A had angina, previous infarction, fail- 
ure or hypertension; over 60% of these pa- 
tients died. Those with previous infarction and 
failure had a 72% and 71% mortality, respec- 
tively. The overall mortality in Group A was 
69%. In Group B, on the other hand, while over 
36% had these accompanying complications, 
only three patients (9%) died. 
The hemodynamic observations in each group 
included the following mean values: In Group 
A, heart rate (HR) 98 (60-149 beats/minute) ; 
stroke index (SI) 18 (7-39 cc/m^) ; cardiac in- 
dex (CI) 1.64 (0.6-3.1 L/min/m2); peripheral 
vascular resistance (PVR) 60.5 (19-136 
mmHg/L/min/m^ or units) ; and LVFP 25 (2- 
60 mmHg). Mean PVR was 49 units in sur- 
vivors and 70 units in nonsurvivors (Fig. 2). 
Depicted in Figure 3 is a hemodynamic sub- 
grouping of shock patients based on cardiac in- 
dex and LVFP. Twenty-five patients with ante- 
rior or inferior infarction, CI less than 2.1 and 
a LVFP greater than 15, had a 100% mortality. 
140 
120 
100 
PVR 
(units) 
40 
Ipf. Ml 
Anl Ml 
IB 
SURVIVORS 
NON-SURVIVORS 
Figure 2. — Peripheral vascular resistance (mmH/L/ 
min/m- or units) plotted for survivors and nonsur- 
vivors in Group A (shock). Mean PVR for survivors 
is indicated at 48.4, and at 70.4 for non-survivors. 
Table I. — Clinical Data for Patients With Cardiogenic Shock and Failure Following 
Acute Infarction 
N0./45 (%) 
Shock 
% Mortality 
Failure 
N0./34 (%) 
% Mortality 
Sex 
Male 
31/45 
(69%) 
68% 
22/34 
(65%) 
5% 
Female 
14/45 
(31%) 
7% 
12/34 
(35%) 
17% 
Age 
Mean 
59 
58 
Range 
29-75 
36-83 
Past medical history 
Angina 
24/45 
(53%) 
66% 
25/34 
(74%) 
8% 
Previous infarction 
18/45 
(40%) 
72% 
14/34 
(41%) 
0% 
Congestive failure - 
21/45 
(47%) 
71% 
12/34 
(35%) 
16% 
Hypertension 
21/45 
(47%) 
61% 
15/34 
(33%) 
20% 
Transmural infarction 
Anterior 
27/45 
(60%) 
82% 
20/34 
(58%) 
10% 
Inferior 
15/45 
(33%) 
53% 
12/34 
(27%) 
0% 
Subendocardial infarction 
Anterior 
1/45 
(2%) 
0% 
9/34 
(26%) 
11% 
Inferior _ 
0/45 
(0%) 
0% 
4/45 
(12%) 
0% 
Left bundle branch block 
3/45 
(7%) 
33% 
2/34 
(6%) 
50% 
Overall mortality 
31/45 
69% 
3/34 
9% 
