Intrarenal Blood Flow in Congestive Heart Failure

Abstract

Intrarenal blood flow distribution was measured by the 133 xenon washout technic in 10 patients with heart disease who were studied at time of left and right heart catheterization. Renal washout curves were analyzed by computer using a weighted least-squares nonlinear regression technic. In three patients with heart disease without edema the compartment I blood flow rates (outer cortex) were not significantly different from those found in nine normal kidney donors. In seven patients with hemodynamic evidence of heart failure and clinical edema the compartment I flow rates were significantly lower than those of the normal control group and of a group of sodium-depleted hypertensive patients. The rate constants of isotope removal from more central regions of the kidney (compartments II and III) were not depressed to a similar degree. Infusion of furosemide into the renal artery induced diuresis in eight studies which was accompained by preferential increases in compartment I flow rates in six. The data suggest that preferential vasoconstriction of renal cortical vessels may contribute to increased sodium retention by the kidneys and to edema formation in patients with congestive heart failure.

Effect of ACE-inhibition on tissue blood flow during acute left ventricular failure in the dog

“…Our values for baseline liver "flow" are about twice as high as those reported by others [6,8,19] which could indicate sphere leakage from the intestines. On the other hand, our results for baseline intestinal flow do not deviate from those of earlier studies [16,19]. Therefore, a definite conclusion regarding leakage cannot be drawn.…”

“…The lost spheres are trapped in the lung and liver, and a relatively high "flow" value in these organs can be explained by a high level of peripheral shunting or leakage or both. Other workers using 15 gm spheres have reported baseline values for lung "flow" that fit fairly well with ours [6,16,19]. This seems to indicate that general perexperimental leakage of microspheres injected in the baseline situation is not present to a high degree in this experimental model.…”

Pathophysiology of Renal Hemodynamics

“…2). It has also been shown that in heart failure, intrarenal blood flow is redistributed re sulting in outer cortical ischemia [18]. Nephrons in this region normally excrete a higher fraction of filtered sodium than juxtamedullary nephrons do.…”

The Mechanism of Adaptation of Left Atrial Stretch Receptors in Dogs with Chronic Congestive Heart Failure

“…The etiology of the altered fluid balance in CHF can be attributed to both hemodynamic (1,3,5,7) and hormonal factors (4,(8)(9)(10)(11). Evidence has been presented by several investigators that the secretion of antidiuretic hormone (ADH) may be altered during CHF or related disease states (12)(13)(14)(15)(16)(17)(18)(19).…”