Measurements of Certain Cardiovascular Responses to Acth and Cortisone in Man*

Horwitz, Orville; Sayen, Ann; Naide, Meyer; Hollander, Joseph Lee

doi:10.1097/00000441-195106000-00011

Cited by 6 publications

(2 citation statements)

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“…The rise in arterial pressure is less than would be expected if the peripheral resistance as a whole had increased to the same extent as the resistance in the cerebral vessels. In fragmentary preliminary studies, ACTH has not consistently changed cardiac output (9)(10)(11). Horwitz and colleagues have reported that the cardiac output frequently decreases in those instances in which ACTH produces a fall in heart rate.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Adrenocorticotrophic Hormone (Acth) on Cerebral Blood Flow and Metabolism 1

Schieve¹,

Scheinberg²,

Wilson³

1951

J. Clin. Invest.

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While patients receiving adrenocorticotrophic hormone (ACTH) often show an increased sense of well-being and mild euphoria, a small number become psychotic. Electroencephalographic (EEG) changes ( 1 ) have been reported in patients receiving ACTH who become psychotic, but the changes have been inconsistently present. In one instance (2) the EEG changes appeared to be related to a decrease in serum potassium level.These observations led to a study of cerebral blood flow and metabolism in patients receiving ACTH. Concurrent investigation of the EEG (3) and of the clinical and metabolic responses of these subjects will be reported elsewhere (4 All of the patients were studied under similar laboratory conditions in the fasting state. The nitrous oxide method originally described by Kety and Schmidt (5) and modified by Scheinberg and Stead (6) was used. The gas mixture used in the determination consisted of approximately 15% N20, 64% N2, and 21% 0. Arterial blood pressure was measured by the auscultatory method with the arm held at heart level. Mean arterial blood pressures were calculated from these readings by adding one third of the pulse pressure to the diastolic pressure. Blood samples for determination of oxygen and glucose contents were drawn just before and following each cerebral blood flow. The A-V oxygen difference was determined by the method described by Hickam and Frayser (7). The blood glucose content was measured by Nelson's (8) photometric adaptation of the Somogyi method. Cerebral oxygen and glucose utilizations were calculated as previously described (5, 6). RESULTSThe results summarized in Table I show a statistically significant decrease in cerebral blood flow on ACTH treatment from 61 to 50 ml./min./100 gm. brain. After approximately 14 days on therapy no further decrease in cerebral blood flow oc-

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Section: Discussionmentioning

confidence: 99%

The Effect of Adrenocorticotrophic Hormone (Acth) on Cerebral Blood Flow and Metabolism 1

Schieve¹,

Scheinberg²,

Wilson³

1951

J. Clin. Invest.

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“…Improved vasomotor activity after intravenous infusions of ACTH was shown by Beattie and Woodmansey (1953). Although Horwitz, Sayen, Naide, and Hollander (1951) found increased digital temperatures after intramuscular ACTH therapy, they were unable to demonstrate a similar effect with cortisone. We, however, had observed a positive effect after cortisone both on digital temperatures and on thermal response.…”

mentioning

confidence: 93%

Effect of Cortisone and Certain Other Steroids on the Peripheral Vasculature in Arthritis

Woodmansey¹,

Beattie²

1955

Annals of the Rheumatic Diseases

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The frequent occurrence of a defective peripheral circulation in rheumatoid arthritis has now been well established since the early observations of Pemberton (1923). Moreover, many of the therapeutic measures employed in this and allied conditions result in an increased peripheral blood flow.After intramuscular injections of adrenocorticotropic hormone (ACTH) changes in the blood flow in the knee joint and an increase in the temperature of the fingers in cases of rheumatoid arthritis were reported by Janus (1950). Improved vasomotor activity after intravenous infusions of ACTH was shown by Beattie and Woodmansey (1953). Although Horwitz, Sayen, Naide, and Hollander (1951) found increased digital temperatures after intramuscular ACTH therapy, they were unable to demonstrate a similar effect with cortisone. We, however, had observed a positive effect after cortisone both on digital temperatures and on thermal response. Moreover, cortisone had earlier been shown plethysmographically by Hines, Wakim, Roth, and Kierland (1950) to produce an increased blood flow in the forearm and legs in cases of scleroderma, and more recently by Catchpole, Jepson, and Kellgren (1954) to cause increased digital blood flow in cases of rheumatoid arthritis.We are here reporting our work on cortisone and on certain other steroids, investigated not only because they have been administered to patients suffering from rheumatoid arthritis, but also because vascular effects have been attributed to some of them.Method The technique employed in these observations was similar to that already in routine use in this Unit, previously described by Woodmansey (1951) and Beattie and Woodmansey (1953). Briefly, it involved skin temperature measurements at various sites (the volar or plantar surfaces of the terminal segments of thumbs and great toes, and the forehead) during a preliminary period of at least 30 minutes, followed by further observations on the exposed limbs during the time of immersion of one leg in a hot-water bath maintained at 44°C. The actual temperatures were recorded with the instrument described in the previous papers. These procedures were carried out, under controlled conditions in a room maintained at a temperature of 18.5-19-55 C., before and after a course of treatment with the steroid.Skin temperature, according to Cooper, Cross, Greenfield, Hamilton, and Scarborough (1949) mirrors the rate of blood flow up to about 340 C. The thermal response involves the stimulation by returning warmed blood of the vasomotor centre in the hypothalamus, and the integrity of the sympathetic system on the efferent side, the resulting vasodilatation depending on inhibition of vasoconstrictor tone, which latter is more marked in the lower than in the upper limbs. ResultsAltogether 57 patients (56 females and one male) were included in this survey, 43 suffering from rheumatoid arthritis and fourteen from osteoarthritis. They were investigated in five groups, each group receiving one of the following steroids: cortisone, testosterone, deoxycortic...

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Cortisone in the Treatment of Osteoarthritis of the Hips

Brown¹

1951

JAMA

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Measurements of Certain Cardiovascular Responses to Acth and Cortisone in Man*

Cited by 6 publications

References 0 publications

The Effect of Adrenocorticotrophic Hormone (Acth) on Cerebral Blood Flow and Metabolism 1

The Effect of Adrenocorticotrophic Hormone (Acth) on Cerebral Blood Flow and Metabolism 1

Effect of Cortisone and Certain Other Steroids on the Peripheral Vasculature in Arthritis

Cortisone in the Treatment of Osteoarthritis of the Hips

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