The Contribution of Local Factors to the Elevated Venous Tone of Congestive Heart Failure

Zelis, Robert

doi:10.1172/jci107756

Cited by 26 publications

(5 citation statements)

References 17 publications

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“…Additionally, a small sample of HF patients (four patients) was analyzed after clinical treatment, suggesting that the venoconstriction found would be reversed with the compensation of congestive HF and that the tone of the peripheral veins could be used as an indicator of HF prognosis [ 97 ]. In accordance with the present study, Zelis [ 98 ] evaluated the calf venous volume of HF patients (NYHA III-IV) by strain gauge plethysmography, confirming a local venous tone elevation in HF [ 98 ]. This venoconstriction was partially restored by α-adrenergic blockade and by administration of a NO donor, with both maneuvers causing venous volume expansion in HF patients, despite the NO donor not being able to reach values obtained in the control group [ 98 ].…”

Section: Venous System In Heart Failuresupporting

confidence: 76%

“…This venoconstriction was partially restored by α-adrenergic blockade and by administration of a NO donor, with both maneuvers causing venous volume expansion in HF patients, despite the NO donor not being able to reach values obtained in the control group [ 98 ]. In such manner, those responses suggested that circulating catecholamines and/or compromised smooth muscle vasodilation may contribute to the higher venous tone in HF [ 98 ].…”

Section: Venous System In Heart Failurementioning

confidence: 99%

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Venous endothelial function in cardiovascular disease

et al. 2022

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The essential role of the endothelium in vascular homeostasis is associated with the release of endothelium-dependent relaxing and contractile factors (EDRF and EDCF, respectively). Different from arteries, where these factors are widely studied, the vasoactive factors derived from the venous endothelium have been given less attention. There is evidence for a role of the nitric oxide (NO), endothelium-dependent hyperpolarization (EDH) mechanism, and cyclooxygenase (COX)-derived metabolites as EDRFs; while the EDCFs need to be better evaluated since no consensus has been reached about their identity in venous vessels. The imbalance between the synthesis, bioavailability, and/or action of EDRFs and/or EDCFs results in a pathological process known as endothelial dysfunction, which leads to reduced vasodilation and/or increased vasoconstriction. In the venous system, endothelial dysfunction is relevant since reduced venodilation may increase venous tone and decrease venous compliance, thus enhancing mean circulatory filling pressure, which maintains or modify cardiac workload contributing to the etiology of cardiovascular diseases. Interestingly, some alterations in venous function appear at the early stages (or even before) the establishment of these diseases. However, if the venous endothelium dysfunction is involved in these alterations is not yet fully understood and requires further studies. In this sense, this article aims to review the current knowledge on venous endothelial function and dysfunction, and the general state of the venous tone in two important cardiovascular diseases of high incidence and morbimortality worldwide: hypertension and heart failure.

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Section: Venous System In Heart Failuresupporting

confidence: 76%

Section: Venous System In Heart Failurementioning

confidence: 99%

Venous endothelial function in cardiovascular disease

et al. 2022

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“…We cannot deny this possibility. Although women with mild preeclampsia had no apparent edema of the hand, we still cannot deny the possibility that the decreased venous distensibility was due to subclinical edema since Zelis 34 demonstrated that patients with heart failure and no apparent edema still had decreased venous distensibility after maximal venodilator stimuli.…”

Section: Venous Distensibility During Preeclampsiamentioning

confidence: 93%

Venous distensibility during pregnancy. Comparisons between normal pregnancy and preeclampsia.

et al. 1994

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Preeclampsia is associated with increased peripheral resistance. This study was performed to determine whether an increase of venous distensibility occurs as well in preeclampsia. We obtained venous distensibility by measuring the venous pressure-volume relation in the forearm with a water-filled plethysmograph. Twenty-one women with normal pregnancy, 12 women with severe preeclampsia, and 8 women with mild preeclampsia were studied during the third trimester and/or 6 weeks after the delivery. Ten nonpregnant normotensive women were also studied. Venous distensibility was greater (P<.01) in normal pregnant women and smaller (P<.01) in women with preeclampsia during pregnancy than postpartum. and decreased intravascular volume.9 ' 10 Changes in venous distensibility in women with preeclampsia are less well documented.The venous system may be important in control of intravascular volume and blood pressure. It has been documented that essential 11 and borderline 12 hypertension are associated with decreased venous distensibility. Decreases in venous distensibility shift the intravascular volume from the peripheral to the central circulation. Thus, it is possible that impaired venous distensibility may contribute to altered hemodynamic status in preeclampsia.Several previous investigators examined venous distensibility in women with preeclampsia. Weinstein et al 13 and Hunyor 14 reported no difference between normal pregnancy and preeclampsia. Stainer et al 15 reported decreased venous distensibility during preeclampsia. However, this study was cross-sectional, and they did not examine whether it was reversible postpartum. Pickles et al 16 reported increased venous distensibility during preeclampsia. Thus, the reported results are variable. The aim of this study was to further evaluate peripheral venous distensibility in preeclampsia during © 1994 American Heart Association, Inc.sibility correlated with the severity of preeclampsia. Venous distensibility was similar between normotensive nonpregnant women, women with nonnal pregnancy during the postpartum period, and women with preeclampsia during the postpartum period. Thus, venous distensibility increased during nonnal pregnancy. In preeclampsia, the decrease of venous distensibility occurred during pregnancy but was reversed postpartum. These results may suggest that a decrease of venous distensibility occurs during preeclampsia. These venous abnormalities may contribute to impaired control of hemodynamics in preeclampsia during pregnancy.

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“…This supports the findings of Pickering et al (5) and his hypothesis that there is a relationship between MVP and low levels of vWF: Ag which may be due to a linked mesenchymal dysplasia.tt " 7 patients with MVP, ruptured chordae tendineae and congestive heart failure had levels of vWF: Ag which were similar to the controls. Increased release of vWF may explain the normal levels in these patients, since patients with congestive heart failure have been shown to be in a generalized state of vasoconstriction with elevated levels of circulating catecholamines (15), and adrenergic stimulation has been shown to increase vWF serum levels (16).…”

Section: Discussionmentioning

confidence: 99%

Von Willebrand Factor and Mitral Valve Prolapse

et al. 1988

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SummaryThe levels of von Willebrand factor (vWF: Ag) were measured in 27 patients with mitral valve prolapse (MVP) and compared to 27 age matched controls. Decreased levels of vWF:Ag (<80%) were found in 59% (16/27) of those with MVP compared to only 7% (2/27) of the controls (p <0.001). Mean vWF: Ag levels were also significantly lower in those with MVP (68 ± 30% versus 100 ± 23%, p <0.001). In those with MVP and congestive heart failure secondary to ruptured chordae tendineae, however, the mean level of vWF:Ag was not significantly different from control values (95 ± 32). There was an increased incidence of recurrent nose bleeds in those with MVP and low levels of vWF: Ag. We conclude that there is a relationship between MVP and low levels of vWF:Ag which may explain the increased incidence of epistaxis in such patients. Increased release of vWF: Ag in those with MVP and concomitant congestive heart failure may account for the normal levels found in this subgroup.

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The Contribution of Local Factors to the Elevated Venous Tone of Congestive Heart Failure

Cited by 26 publications

References 17 publications

Venous endothelial function in cardiovascular disease

Venous endothelial function in cardiovascular disease

Venous distensibility during pregnancy. Comparisons between normal pregnancy and preeclampsia.

Von Willebrand Factor and Mitral Valve Prolapse

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