Identification of normal neurohormonal activity in mild congestive heart failure and stimulating effect of upright posture and diuretics

摘要: To characterize further the pathophysiology of neurohormonal vasoconstrictor pathways in congestive heart failure (CHF), plasma renin activity, norepinephrine, blood pressure, volume and renal hemodynamics were measured 12 patients with mild to moderate CHF. In addition, response gravitational stress head-up tilt influence 3 weeks furosemide treatment as stimuli activity assessed. Supine before diuretics was relatively normal at 1.94 +/- 1.6 ng/ml/hr significantly increased 3.9 2.7 after diuretics. During tilt, there a significant reflex increase both Plasma norepinephrine also (325 211 pg/ml), did not diuretics, but showed increases during Diuretic administration led decreases systolic diastolic pressures, no change body weight or total volume. diuretic result any changes flow (546 119 634 204 ml/min/1.73m2), glomerular filtration rate (81 22 90 27 ml/min/1.73m2) fraction (0.26 0.25). The present study demonstrates that renin-angiotensin system sympathetic nervous activated early symptomatic stages CHF baroreceptor stimulation these preserved. Renin secretion administration, suggesting macula densa signal for release preserved