Studies in Congestive Heart Failure. Xxiiii. A Critical Study of Methods for Determining the Cardiac Output in Patients With Cardiac Disease

Arthur, GH; Friedman, Ben; Clark, Gurney; Harrison, Tinsley R.

doi:10.1172/jci100536

Cited by 48 publications

(15 citation statements)

References 5 publications

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“…That recirculation is the main source of error is also shown by the fact that, in patients with slow circulation, e.g., cardiac failure, gas inhalation methods give values for arteriovenous oxygen difference that equal those obtained with the direct Fick principle, 90 to 100 cc. per liter of blood (3,13,23 4. The rebreathing procedure did not change the oxygen content in the pulmonary artery blood during the 27 seconds that the rebreathing lasted.…”

Section: Resultsmentioning

confidence: 99%

A Comparison of the Direct Fick and the Grollman Methods for Determination of the Cardiac Output in Man

Werkö¹,

Berseus²,

Lagerlof³

1949

J. Clin. Invest.

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Section: Resultsmentioning

confidence: 99%

A Comparison of the Direct Fick and the Grollman Methods for Determination of the Cardiac Output in Man

Werkö¹,

Berseus²,

Lagerlof³

1949

J. Clin. Invest.

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“…The venous tone in the hand was measured by the method of Capps (18), and the venous pressure by the direct method of Moritz and Tabora (19). The cardiac output was measured by the acetylene method (20), and the basal metabolism by oxygen consumption. The histamine method was used for determining the circulation time (21).…”

Section: Methodsmentioning

confidence: 99%

MECHANISM OF THE ARTERIAL HYPERTENSION INDUCED BY PAREDRINOL (α-N-DIMETHYL-p-HYDROXYPHENETHYLAMINE

Stead¹,

Kunkel²

1939

J. Clin. Invest.

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In arterial hypertension the cardiac output, the metabolic rate, and the usual blood chemical constituents are essentially normal. Experimental hypertension in man, however, is usually attended by alterations in some of these measurements. Epinephrine produces hypertension in normal subjects, but at the same time it usually increases the heart rate and cardiac output. It elevates the basal metabolism, the blood flow in the muscles, the blood sugar and the blood lactic acid, and also causes great vasoconstriction in the skin vessels. This hypertension is therefore in no way comparable to that observed in disease. The study to be reported indicates that in normal subjects paredrinol sulphate 1 (a-N-dimethyl-p-hydroxyphenethylamine sulphate) produces a type of hypertension which has many features in common with clinical hypertension. For this reason the circulatory adjustments following the administration of this drug are of particular interest.The pharmacology of paredrinol, a sympathomimetic drug closely allied in structure to ephedrine, has been studied extensively in animals. Rein (1, 2), in an investigation of the action of paredrinol on dogs anesthetized with morphine and pernocton, found that both the arterial pressure and the minute volume output of the heart were elevated. The drug acted first on the venous side of the circulation, and produced a greater venous return to the heart by increasing the venous tone and probably by emptying out the liver. This was followed in a few seconds by a slow increase in arterial tone and, shortly thereafter, by a powerful discharge of blood from the abdominal organs, particularly the spleen. Rein claimed that this intense 'discharge of blood from 1 The paredrinol sulphate used in this study was obtained through the courtesy of the Smith, Kline, and French Laboratories. This drug has been reported in the German literature under the trade names "veritol" and " H 75 " (Knoll).the abdominal venous reservoirs indicated that the main cause for the rise in arterial pressure was an increase in venous return to the heart, rather than an increase in peripheral resistance. He demonstrated that the blood flow in the extremities and in the abdominal viscera was never greatly decreased and at times was increased. Since the drug did not cause blanching when introduced into the human skin, he concluded that the capillaries were not constricted and that the arterial tone was increased in the larger vessels.Heymans and Bayless (3), on the basis of experiments conducted on anesthetized dogs, concluded that the vascular effect of the drug was characterized by slight peripheral vasoconstriction and pronounced splanchnic vasoconstriction. When the physiological reflexes for the proprioceptive regulation of blood pressure were depressed by means of barbiturates, they were not restored by paredrinol, even though the blood pressure was raised. Lindner (4), working with isolated cats'-hearts, demonstrated that paredrinol in concentrations of 1 to 1,000,000 increased the frequency and strength of ...

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“…MATERIAL (12). The values reported represent the average of two or more measurements made at the same level of basal metabolism.…”

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confidence: 99%

The Minute Volume Output and the Work of the Heart in Hypothyroidism 12

Altschule

Volk²

1935

J. Clin. Invest.

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Close association between aberrations in the function of the thyroid gland and disturbances in the physiology of the cardiovascular system has long been recognized. Because of the frequent occurrence of evidences of heart disease in patients with thyrotoxicosis many investigators have studied the cardiac minute volume output and other aspects of the circulation in this disease. In hypothyroidism, on the other hand, evidences of disturbed cardiovascular function are less prominent, and the cardiac output accordingly has been less thoroughly investigated.In 1925, Means (1) reported marked dinminution in the cardiac minute volume output in two cases of myxedema studied by Field and Bock. Two years later, Mobitz (2) observed a decrease in the cardiac output in one patient with myxedema, and Kininmonth (3) likewise observed a decrease in two additional cases. The results of the two latter observers are difficult to interpret, since the validity of the original ethyl iodide method (4) which they utilized has been questioned. Several years later, Bansi (5) (6) using the methods of Douglas and Haldane (7) and of Grollman (8), also found decreased cardiac output in three patients with myxedema.The recent work of Blumgart and his associates (9) (10) (11) in establishing the value of total ablation of the normal thyroid gland in the treatment of chronic intractable heart disease made it advisable to study the cardiac output and related aspects of the circulation in hypothyroidism induced by this operation. tion of the thyroid gland performed for the relief of angina pectoris. Studies were made in two, both before, and at different levels of basal metabolism after operation; in one other, observations were made at three different levels of metabolism after operation. Patients with no history of congestive failure were chosen for this study in order to avoid the complicating effect of cardiac decompensation on the output of the heart. Four subjects were males and three females; the ages varied from 53 to 65 years. Several patients showed slight elevation of the blood pressure; all presented slight to moderate sclerosis of the peripheral arteries. The hemoglobin in every instance was 90 per cent or above. Studies were made only in patients with hypothyroidism who could be trained to breathe as deeply and as rapidly as is necessary for measurement of the cardiac output by the acetylene method. The decreased oxygen consumption in hypothyroidism results in a diminution of the oxygen difference between the consecutive gas samples taken for analysis. This increases the percentage deviation from the average of repeated measurements of the cardiac output; it was not possible to obtain reliable results in several patients. As indicated in Table I, many patients were receiving small doses of dessicated thyroid gland (Armour) at the time of study.All measurements were made in the postabsorptive state, under basal conditions with the patients in the semi-recumbent position, after a rest of. one-half to one hour. The basal metabolic rate...

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Studies in Congestive Heart Failure. Xxiiii. A Critical Study of Methods for Determining the Cardiac Output in Patients With Cardiac Disease

Cited by 48 publications

References 5 publications

A Comparison of the Direct Fick and the Grollman Methods for Determination of the Cardiac Output in Man

A Comparison of the Direct Fick and the Grollman Methods for Determination of the Cardiac Output in Man

MECHANISM OF THE ARTERIAL HYPERTENSION INDUCED BY PAREDRINOL (α-N-DIMETHYL-p-HYDROXYPHENETHYLAMINE

The Minute Volume Output and the Work of the Heart in Hypothyroidism 12

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