The Effects of Exercise on Cardiovascular and Renal Function in Cardiac Patients With and Without Heart Failure 1

Abstract

Exercise in the upright position results in the retention of salt and water in normal subjects (1-5) and in patients with congestive failure (6). The mechanisms which set off these antidiuretic and antisaluretic responses are not definitely known. The following factors have been considered: 1) Sensory stimuli from the legs; 2) upright position; 3) hemoconcentration; 4) reduction and/or redistribution of the effective circulating blood volume; 5) metabolic products or alteration of acid-base balance; and 6) a relatively inadequate cardiac output resulting in a tendency to hypotension or collapse. Studies in this laboratory on normal subjects in the supine position showed that strenuous exercise (alternate straight leg-raising) does not regularly produce such antidiuretic and antisaluretic responses (7). In the present investigation the study was extended to include patients with valvular and non-

A Correlation of Clinical and Hemodynamic Studies in Patients With Hypothyroidism1

“…In the patients with congestive failure, on the other hand, the elevated atrial pressures became significantly more abnormal despite the failure of cardiac output to increase, and calculated systemic resistance did not decrease. Pulmonary arterial pressures and calculated total pulmonary resistances in patients with congestive failure are high at rest and become more abnormal during exercise (45)(46)(47). It is suggested that in hypometabolism the somewhat higher than expected right atrial, right ventricular end diastolic and pulmonary arterial mean pressures, and the presence of diastolic dips on the right ventricular pressure tracings found in patients with enlarged cardiac silhouettes may well reflect the effects of pericardial effusion and not the presence of myocardial failure.…”

The Role of Anaerobic Metabolism in the Performance of Mild Muscular Work. I. Relationship to Oxygen Consumption and Cardiac Output, and the Effect of Congestive Heart Failure1

“…Patients with pulmonary disease (35) and anemia (36) at rest have the same CVo2 when in heart failure as before failure occurs. PVo2 falls lower in many anemic patients who have compensated hearts than is ever found in ordinary patients with decompensation (37).…”