SUMMARYIn 10 patients with coarctation of the aorta, plasma renin activity was measured after recumbency and orthostatism in peripheral venous blood and, in some cases, in renal venous blood also. In nine of these patients, basic plasma renin values and those obtained under stimulatory conditions lay within normal range, and only in one patient were the values elevated. However, since this patient displayed the lowest gradient of mean arterial blood pressure proximal and distal to the stenosis, it can be regarded as improbable that the elevation in plasma renin activity was caused by the coarctation. Plasma renin activity in the renal venous blood of both kidneys, which was measured in three patients, showed no elevation.On the basis of observations of other authors and of our own studies it can be concluded that the kidneys can contribute to the development of prestenotic hypertension in acute constriction of the aorta in experiments with animals, but in chronic coarctation in animals or in man the humoral or renal theory has no importance to the pathogenesis of hypertension.
Die Plasma-Renin-Aktivität war bei Conn-Syndrom und renovaskulärer Hypertonie unter Basisbedingungen eindeutig verschieden von derjenigen bei Normalpersonen, bei essentieller Hypertonie und in Fällen von Hypertonie bei entzündlichen Nierenleiden. Unter Stimulationsbedingungen bestanden zwischen den Werten bei essentieller Hypertonie und beim Conn-Syndrom einerseits und den Werten der übrigen Gruppen andererseits signifikante Unterschiede. Die renovaskuläre Hypertonie und die Hypertonie bei entzündlichen Nierenleiden unterschieden sich unter Stimulationsbedingungen nicht signifikant. Patienten mit einem Phäochromozytom hatten teils erhöhte und teils normale Werte. Die Plasma-Renin-Aktivität unter Basis-und Stimulationsbedingungen war unabhängig vom Schweregrad der Hypertonie und der Nierenfunktion, solange es nicht zur Arteriolonekrose, das heißt zur malignen Verlaufsform, kam. Erst dann wurden deutlich erhöhte Werte festgestellt. * Diese Arbeit wurde durch die Hilfe des Schweizerischen Nationalfonds zur Förderung der wissenschaftlichen Forschung und der Stiftung der wissenschaftlichen Forschung an der Universität Zürich ermöglicht. Nr. 20, 16. Mai1969, 94. Jg.Endres u. a.: Die Plasma.Renin-Aktivität Im peripheren venösen Blut unter verschiedenen Stimulationsbedingungen 1049Heruntergeladen von: NYU. Urheberrechtlich geschützt.
The effect of successful aortocoronary artery bypass surgery on left ventricular (LV) function was studied by angiography in 13 patients with coronary-artery disease and resection of a ventricular aneurysm. The following were calculated from single-plane right anterior oblique LV cine-angiograms: LV end-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF), percentage shortening of the medial perpendicular short axis (deltaM), mean velocity shortening of the circumferential fibres (VCF). The changes in the five hemi-axes of the anterior LV wall, and five of the inferior wall were averaged to give a value for relative anterior wall motion (SMV) and inferior wall motion (SMH). Changes in apical motion (SMS) were calculated from the percentage changes in the base-to-apex axis. The following mean values (x plus or minus s) were obtained four months before and 11 months after aneurysmectomy: EDVI (ml/m2) 154 plus or minus 27 (126 plus or minus 23), ESVI (ml/m2) 107 plus or minus 28 (56 plus or minus 15), SVI (ML/M2) 46.5 plus or minus 12.7 (69.9 plus or minus 23.1), EF (%) 32.6 plus or minus 8.0 (54.6 plus or minus 12.0), SMV (%) 6.1 plus or minus 10.0 (25.0 plus or minus 13.4), SMH (%) 25.9 plus or minus 13.1 (31.2 plus or minus 11.1), SMS (%) 5.1 PLus or minus 3.4 (13.1 plus or minus 4.2). These results indicated significant improvement in ventricular pumping action and wall motion after aneurysm resection and aortacoronary bypass surgery in patients with coronary-artery disease and severe cardiac failure.
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