Haemodynamic and neurohumoral response in heart failure produced by rapid ventricular pacing.

摘要: Objective: The aim was to determine the exact sequence of hormone changes during progression fluid retention in a canine model “congestive cardiac failure” induced by rapid right ventricular pacing, and recovery when pacing is stopped. Methods: Rapid at rate 250 pulses·min−1 used six mongrel dogs with implanted pacemakers. Right heart haemodynamics were measured means Swan Ganz catheterisation, allowing flow measurement thermodilution pressure external manometry. Plasma renin activity, arginine vasopressin, atrial natriuretic factor assayed on venous blood samples radioimmunoassay. Noradrenaline high liquid chromatography. Results: onset accompanied fall output rise pulmonary arterial, capillary wedge, pressures. rose. activity showed an initial followed rise, vasopressin unchanged first 8 h. When continued for further 35 d, clinical signs appeared day 28, which time had fallen, central pressures risen further. Atrial peaked around 14 d whereas plasma noradrenaline tended reach plateau about 20 then show increases as appeared; this most marked activity. Cessation caused reversal (increase) but more gradual (decrease) over 5 d; only wedge returned base line. Arginine fell rapidly 40% final levels reached basal values after h 48 respectively. d. quickly 60% remained above At end body weight conjunction large diuresis. Conclusions: These findings are compatible major role one or renin, pathophysiology failure; manifestations not counteracted factor.