Hyperaldosteronism in Heart-Disease

Wolff, H. P.; Koczorek, K. H. R.; Buchborn, E

doi:10.1016/s0140-6736(57)92543-6

Cited by 64 publications

(14 citation statements)

References 8 publications

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“…• Hypersecretion of aldosterone is common in edematous states (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). Many patients with congestive heart failure have increased secretion and excretion of aldosterone (1,(3)(4)(5)(6)(7), but patients with edema also have normal rates of secretion, of this hormone (8)(9)(10).…”

Section: Additional Abstractmentioning

confidence: 99%

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Plasma Renin in Chronic Experimental Heart Failure and during Renal Sodium "Escape" from Mineralocorticoids

Johnston

Davis

Robb

et al. 1968

Circulation Research

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A striking increase in the plasma renin level occurred in dogs with low output right heart failure secondary to tricuspid insufficiency and pulmonic stenosis and in three of five animals with high output failure produced by a large arteriovenous fistula. When dogs with a small arteriovenous fistula were given daily injections of DOCA, the renal sodium "escape" phenomenon occurred. In these animals, the level of plasma renin was suppressed during DOCA administration both during the initial period of sodium retention and also later when sodium balance was normal or negative. In contrast, when dogs with a larger arteriovenous fistula but without evidence of cardiac failure were given DOCA, they retained sodium and developed signs of congestive heart failure. However, in these animals with congestion and ascites, in contrast to-the dogs that developed spontaneous high output failure, the plasma renin was low. Renin-substrate was unaltered in all of the experimental situations studied except for the decrease observed in dogs with low output right heart failure, la these animals, it seems likely that decreased renin-substrate was secondary to hepatic congestion and liver damage. The renin-angiotensin system does not seem to be related to the "escape" phenomenon, and renin does not appear to be the factor that makes the kidney unusually responsive to mineralocorticoids. Thus, in experimental heart failure the reninangiotensin system was activated, but in the congestive syndrome produced by DOCA the plasma renin level was suppressed. ADDITIONAL KEY WORDSrenin-angiotensin system arteriovenous fistula desoxycorticosterone sodium balance renin-substrate tricuspid insufficiency and pulmonic stenosis high output failure conscious dogs• Hypersecretion of aldosterone is common in edematous states (1-12). Many patients with congestive heart failure have increased secretion and excretion of aldosterone (1, 3-7), but patients with edema also have normal rates of secretion, of this hormone (8-10). Experimental heart failure in dogs is regularly accompanied by an increase in aldosteroneFrom the Departments of Physiology and Surgery, University of Missouri School of Medicine, Columbia, Missouri 6520X.This investigation was supported in part by U. S. Public Health Service Research Grant HE 10612-01 from the National Heart Institute.Dr. Johnston is Research Fellow, National Heart Foundation of Australia.Accepted for publication December 10, 1967. secretion and a high plasma level of aldosterone (2,11,12). The increase in plasma aldosterone in heart failure also results from a decrease in the metabolic clearance of aldosterone by the Ever (4, 9, 13). The present study relates the participation of the reninangiotensin system in experimental heart failure to sodium balance and to the known hypersecfetion of aldosterone. This investigation is also concerned with the role of the renin-angiotensin system in the "escape" phenomenon (14-15). Normal humans or animals given large quantities of a mineralocorticoid retain sodium for only ...

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Section: Additional Abstractmentioning

confidence: 99%

“…Many patients with congestive heart failure have increased secretion and excretion of aldosterone (1,(3)(4)(5)(6)(7), but patients with edema also have normal rates of secretion, of this hormone (8)(9)(10). Experimental heart failure in dogs is regularly accompanied by an increase in aldosterone…”

Section: Additional Abstractmentioning

confidence: 99%

Plasma Renin in Chronic Experimental Heart Failure and during Renal Sodium "Escape" from Mineralocorticoids

Johnston

Davis

Robb

et al. 1968

Circulation Research

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“…These patients had normal urinary levels of aldosterone. 4. It is concluded that, in man, aldosterone does not play a consistently primary role in the production or maintenance of cardiac edema.…”

Section: Resultsmentioning

confidence: 96%

Aldosterone and the Edema of Congestive Heart Failure

Sanders¹

1964

Arch Intern Med

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“…Similar variability was found in aldosterone excretion rates in congestive heart failure. Some found increased aldosterone excretion rates [62,132] while others did not [71,84], Laragh [59] reported that in con trast to patients with cirrhosis and nephrotic syndrome, most patients with congestive heart failure had normal aldosterone secretion rates. More re cently, Vandongen and G ordon [120] found that plasma renin activity was low in patients with untreated cardiac failure and gradually increased with natriuresis.…”

Section: Edematous Statesmentioning

confidence: 99%

Renin and the Kidney

Chonko¹,

Stein²,

Ferris³

1975

Nephron

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The factors involved in renin release have been extensively evaluated. The primary determinants are the transmural pressure at the afferent arteriole, sodium delivery to the macula densa, and the activity of the adrenergic nervous system. Other possible factors include circulating catecholamines, the serum and cerebrospinal fluid sodium concentration, serum potassium concentration, angiotensin II concentration, and antidiuretic hormone release. There is no convincing evidence that the renin-angiotensin system mediates renal autoregulation. Plasma renin activity is altered in a number of clinical settings. This parameter is elevated in most patients with cirrhosis and the nephrotic syndrome as well as in individuals with severe congestive heart failure. Despite inappropriately large weight gains, plasma renin suppresses normally with increased salt intake in edematous patients who have a normal glomerular filtration rate. The mechanisms of the alteration in the renin-angiotensin system in Bartter’s syndrome is still not clear.

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Hyperaldosteronism in Heart-Disease

Cited by 64 publications

References 8 publications

Plasma Renin in Chronic Experimental Heart Failure and during Renal Sodium "Escape" from Mineralocorticoids

Plasma Renin in Chronic Experimental Heart Failure and during Renal Sodium "Escape" from Mineralocorticoids

Aldosterone and the Edema of Congestive Heart Failure

Renin and the Kidney

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