Hormonal changes in patients with severe chronic congestive heart failure treated by ultrafiltration

摘要: Plasma atrial natriuretic peptide (ANP), antidiuretic hormone (ADH), plasma renin activity (PRA), and circulatory haemodynamics were studied in five patients with chronic congestive heart failure undergoing ultrafiltration on two consecutive days. The the New York Heart Association class IV, considered candidates for transplantation. A mean of 3.3 +/- 0.5 litres fluid was removed during each ultrafiltration. ANP concentration remained unchanged ultrafiltration: 369 151 pg/ml at start 316 116 end, while ADH PRA increased from 5.1 2.1 to 7.5 3.4 (P less than 0.02), 5.9 3.0 7.7 3.2 ng/ml 0.03) respectively (n = 10). After treatment, declined baseline values within 1 h. Pulmonary artery, pulmonary capillary wedge, right pressures decreased significantly, blood pressure rate constant volume removed, caused an increase colloid osmotic 22.0 33.7 3.9 mmHg 0.02). It unexpected that did not decline. Due long-standing severe wall may have lost some its elastic properties, resulting ability adapt reduced filling pressures. Accordingly, stretch unchanged, explaining levels. Ultrafiltration treatment responsiveness diuretic therapy, four survived long enough receive transplants.