Circulation, Vol 80, 299-305, Copyright © 1989 by American Heart Association
IS Anand, R Ferrari, GS Kalra, PL Wahi, PA Poole-Wilson and PC Harris
This study provides data on plasma hormone levels in patients with severe
clinical congestive cardiac failure who had never received therapy and in
whom the presence of an accumulation of excess water and sodium had been
established. Eight patients were studied; two had ischemic cardiac disease,
and six had dilated cardiomyopathy. Mean hemodynamic measurements at rest
were as follows: cardiac index, 1.8 l/min/m2; pulmonary wedge pressure, 30
mm Hg; right atrial pressure, 15 mm Hg. Total body water content was 16%
above control, extracellular liquid was 33% above control, plasma volume
was 34% above control, total exchangeable sodium was 37% above control,
renal plasma flow was 29% of control, and glomerular filtration rate was
65% of control. Plasma norepinephrine was consistently increased (on
average 6.3 times control), whereas adrenaline was unaffected. Although
plasma renin activity and aldosterone varied widely, they were on average
above normal (renin 9.5 times control, aldosterone 6.4 times control).
Plasma atrial natriuretic peptide (14.3 times control) and growth hormone
(11.5 times control) were consistently increased. Cortisol was also
increased on average (1.7 times control). Vasopressin was increased only in
one patient.
ARTICLES
Edema of cardiac origin. Studies of body water and sodium, renal function, hemodynamic indexes, and plasma hormones in untreated congestive cardiac failure
Department of Cardiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
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