Artigo Revisado por pares

ELECTROLYTES AND CONGESTIVE FAILURE

1952; American College of Physicians; Volume: 37; Issue: 3 Linguagem: Inglês

10.7326/0003-4819-37-3-453

ISSN

1539-3704

Autores

T. S. Danowski,

Tópico(s)

Potassium and Related Disorders

Resumo

Article1 September 1952ELECTROLYTES AND CONGESTIVE FAILURET. S. DANOWSKI, F.A.C.P.T. S. DANOWSKI, F.A.C.P.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-37-3-453 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIn individuals with an efficient circulation, adequate renal function and an effective endocrine system, a variety of adjustments contrives to maintain body water and electrolyte stores quite constant.1a-cIt is now generally acknowledged that these mechanisms are no longer normally operative in congestive failure. The increases in body sodium, chloride and water which constitute the edema of congestive failure must be based ultimately on an undue retention of these constituents as taken in the diet. It is appropriate, therefore, to review the evidence which points to etiologic and contributory factors in producing such positive balances of body water and electrolytes....Bibliography1. Danowski TS(a) : Newer concepts of the role of sodium in disease, Am. J. Med. 10: 468-480, 1951. (b) Danowski, T. S., and Elkinton, J. R.: Exchanges of potassium related to organs and systems, Pharmacol. Rev. 3: 42-58, 1951. (c) Elkinton, J. R., and Squires, R. D.: The distribution of body fluids in congestive heart failure. I. Theoretic considerations, Circulation 4: 679-696, 1951. CrossrefMedlineGoogle Scholar2. Hope J: A treatise on the diseases of the heart, 1846, Lea & Blanchard, Philadelphia. Google Scholar3. Cohnheim J: Lectures on general pathology, 1889, New Sydenham Society, London. Google Scholar4. Starling EH(a) : On the absorption of fluids from the connective tissue spaces, J. Physiol. 19: 312-326, 1896. (b) Starling, E. H.: The fluids of the body, 1909, Archibald Constable and Co., London. CrossrefMedlineGoogle Scholar5. Landis EM(a) : The passage of fluid through the capillary wall, Am. J. M. Sc. 193: 297-313, 1937. (b) Harrison, T. R.: Failure of the circulation, 1939, The Williams & Wilkins Company, Baltimore. CrossrefGoogle Scholar6. Mackenzie J: Diseases of the heart, 3d Ed., 1914, H. Frowde, London. Google Scholar7. SeymourPritchardLongleyHayman WBWHLPJM(a) : Cardiac output, blood and interstitial fluid volumes, total circulating serum protein and kidney function during cardiac failure and after improvement, J. Clin. Investigation 21: 229-240, 1942. (b) Stead, E. A., Jr., Warren, J. V., Merrill, A. J., and Brannon, E. S.: The cardiac output in male subjects as measured by the technic of right atrial catheterization. Normal values with observations on the effect of anxiety and tilting, J. Clin. Investigation 24: 326-331, 1945. (c) Stead, E. A., Jr., Warren, J. V., and Brannon, E. S.: Cardiac output in congestive heart failure. An analysis of the reasons for lack of close correlation between the symptoms of heart failure and the resting cardiac output, Am. Heart J. 35: 529-541, 1948. (d) Hickam, J. B., and Cargill, W. H.: Effect of exercise on cardiac output and pulmonary arterial pressure in normal persons and in patients with cardiovascular disease and pulmonary emphysema, J. Clin. Investigation 27: 10-23, 1948. CrossrefMedlineGoogle Scholar8. Sharpey-Schafer EP(a) : Cardiac output in severe anaemia, Clin. Sc. 5: 125-132, 1944. (b) Brannon, E. S., Merrill, A. J., Warren, J. V., and Stead, E. A., Jr.: The cardiac output in patients with chronic anemia as measured by the technique of right atrial catheterization, J. Clin. Investigation 24: 332-336, 1945. (c) Merrill, A. J., and Cargill, W. H.: Mechanism of edema formation in thyrotoxic heart disease, Am. J. Med. 3: 502-503, 1947. Google Scholar9. GibsonEvans JGWA(a) : Clinical studies of the blood volume. III. Changes in blood volume, venous pressure and blood velocity rate in chronic congestive heart failure, J. Clin. Investigation 16: 851-858, 1937. (b) Meneely, G. R., and Kaltreider, N. L.: A study of the volume of the blood in congestive heart failure. Relation to other measurements in fifteen patients, J. Clin. Investigation 22: 521-530, 1943. (c) Richards, D. W., Jr.: Dynamics of congestive heart failure, Am. J. Med. 6: 772-780, 1949. (d) Prentice, T. C., Berlin, N. I., Hyde, G. M., Parsons, R. J., Lawrence, J. H., and Port, S.: Total red cell volume, plasma volume, and sodium space in congestive heart failure, J. Clin. Investigation 30: 1471-1482, 1951. CrossrefMedlineGoogle Scholar10. Stead EA(a) : Edema of heart failure, Bull. New York Acad. Med. 24: 607-614, 1948. (b) Little, J. M.: A unified concept of cardiac failure, Am. J. Med. 7: 207-215, 1949. (c) McMichael, J.: Cardiac venous congestion. Its causes and consequences, Am. J. Med. 6: 651-661, 1949. MedlineGoogle Scholar11. RichardsCournandDarlingGillespie DWARCWH(a) : Pressure in the right auricle of man, in normal subjects and in patients with congestive heart failure, Tr. A. Am. Physicians 56: 218-221, 1941. (b) Richards, D. W., Jr., Cournand, A., Darling, R. C., Gillespie, W. H., and Baldwin, E. de F.: Pressure of blood in the right auricle in animals and in man: under normal conditions and in right heart failure, Am. J. Physiol. 136: 115-123, 1942. (c) Reichsman, F., and Grant, H.: Some observations on the pathogenesis of edema in cardiac failure, Am. Heart J. 32: 438-442, 1946. (d) Landis, E. M., Brown, E., Fauteux, M., and Wise, C.: Central venous pressure in relation to cardiac "competence," blood volume and exercise, J. Clin. Investigation 25: 237-255, 1946. (e) Bloomfield, R. A., Lauson, H. D., Cournand, A., Breed, E. S., and Richards, D. W., Jr.: Recording of right heart pressures in normal subjects and in patients with chronic pulmonary disease and various types of cardio-circulatory disease, J. Clin. Investigation 25: 639-664, 1946. (f) Bloomfield, R. A., Rapoport, B., Milnor, J. P., Long, W. K., Mebane, J. G., and Ellis, L. B.: The effects of the cardiac glycosides upon the dynamics of the circulation in congestive heart failure. I. Ouabain, J. Clin. Investigation 27: 588-599, 1948. (g) Harvey, R. M., Ferrer, M. I., Cathcart, R. T., Richards, D. W., Jr., and Cournand, A.: Some effects of digoxin upon the heart and circulation in man. Digoxin in left ventricular failure, Am. J. Med. 7: 439-453, 1949. (h) Farber, S. J., Alexander, J. D., Pellegrino, E. D., and Earle, D. P.: The effect of intravenously administered digoxin on water and electrolyte excretion and on renal functions, Circulation 4: 378-386, 1951. (i) Davies, C. E.: Effect of treatment on renal circulation in heart failure, Lancet 2: 1052-1057, 1951. Google Scholar12. Karrel P: De la cure de lait, Arch. gén. de méd. 8: 513-533, 1866. Google Scholar13. AchardLoeper CM(a) : Sur la rétention des chlorures dans les tissus au cours de certains états morbides, Compt. rend. Soc. de biol. 53: 346-347, 1901. (b) Merklen, P.: La rétention du chlorure de sodium dans l'oedème cardiaque, Bull. et mém. Soc. méd. d. hôp. de Paris 20: 725-731, 1903. (c) Widal and Lemierre: Pathogénie de certains oedèmes brightiques; action du chlorure de sodium ingére, Bull. et mém. Soc. méd. d. hôp. de Paris 20: 785-788, 1903. Google Scholar14. Schroeder HA(a) : Studies on congestive heart failure. I. The importance of restriction of salt as compared to water, Am. Heart J. 22: 141-153, 1941. (b) Futcher, P. H., and Schroeder, H. A.: Studies on congestive heart failure. II. Impaired renal excretion of sodium chloride, Am. J. M. Sc. 204: 52-62, 1942. CrossrefGoogle Scholar15. Schemm FR(a) : Certain clinical aspects of the application of water balance principles to heart and kidney disease, Ann. Int. Med. 30: 92-99, 1949. (b) Wolf, A. V.: The dehydrating effect of continuously administered water, Am. J. Physiol. 143: 567-571, 1945. LinkGoogle Scholar16. BridgesWheelerWhite WCEOPD(a) : Low-sodium diet and free fluid intake in the treatment of congestive heart failure, New England J. Med. 234: 573-578, 1946. (b) Leevy, C. M., Strazza, J. A., and Jaffin, A. E.: Fluids in congestive heart failure, J. A. M. A. 131: 1120-1125, 1946. (c) Gorham, L. W., Lester, D. E., Wolf, A. V., and Shultz, H. H.: The relative importance of dietary sodium chloride and water intake in cardiac edema, Ann. Int. Med. 27: 575-583, 1947. CrossrefMedlineGoogle Scholar17. StarrRawson IAJ(a) : Role of the "static blood pressure" in abnormal increments of venous pressure, especially in heart failure. I. Theoretical studies on an improved circulation schema whose pumps obey Starling's law of the heart, Am. J. M. Sc. 199: 27-39, 1940. (b) Starr, I.: Role of the "static blood pressure" in abnormal increments of venous pressure, especially in heart failure. II. Clinical and experimental studies, Am. J. M. Sc. 199: 40-55, 1940. (c) Starr, I., Jeffers, W. A., and Meade, R. H., Jr.: The absence of conspicuous increments of venous pressure after severe damage to the right ventricle of the dog, with a discussion of the relation between clinical congestive failure and heart disease, Am. Heart J. 26: 291-301, 1943. (d) Starr, I.: Our changing viewpoint about congestive failure, Ann. Int. Med. 30: 1-37, 1949. CrossrefGoogle Scholar18. ProgerGinsburgMagendantz SEH(a) : The effects of the ingestion of excessive amounts of sodium chloride and water on patients with heart disease, Am. Heart J. 23: 555-566, 1942. (b) Warren, J. V., and Stead, E. A., Jr.: Fluid dynamics in chronic congestive heart failure; interpretation of mechanisms producing edema, increased plasma volume and elevated venous pressure in certain patients with prolonged congestive failure, Arch. Int. Med. 73: 138-147, 1944. (c) Wheeler, E. O., Bridges, W. C., and White, P. D.: Diet low in salt (sodium) in congestive heart failure, J. A. M. A. 133: 16-20, 1947. (d) Newman, W., and Fishel, L.: Observations on the daily changes in venous pressure and weight in a case of chronic congestive heart failure, Circulation 1: 706-711, 1950. CrossrefGoogle Scholar19. GreenmanPetersMateerWeigandWilkinsTarailRhodesDanowski LJHFMFADRGTS: Biochemical changes accompanying the ingestion of a carboxylic cation exchanger in the hydrogen, ammonium, sodium, potassium, or calcium form, J. Clin. Investigation 30: 995-1008, 1951. CrossrefMedlineGoogle Scholar20. BergerQuinnHomer EYGPMA: Effect of desoxycorticosterone on the colon: its relation to the action of cation exchange resins in man, Proc. Soc. Exper. Biol. and Med. 76: 601-604, 1951. CrossrefMedlineGoogle Scholar21. FreybergGrant RHRL: Loss of minerals through the skin of normal humans when sweating is avoided, J. Clin. Investigation 16: 729-731, 1937. CrossrefMedlineGoogle Scholar22. SquiresCrosleyElkinton RDAPJR: The distribution of body fluids in congestive heart failure. III. Exchanges in patients during diuresis, Circulation 4: 868-880, 1951. CrossrefMedlineGoogle Scholar23. HigbesTurnerMoseleyMerrill DJHHAJAJ: Mechanisms of salt and water retention in heart failure, Am. J. Med. 7: 249, 1949. CrossrefGoogle Scholar24. Merrill AJ(a) : Edema and decreased renal blood flow in patients with chronic congestive heart failure: Evidence of "forward failure" as the primary cause of edema, J. Clin. Investigation 25: 389-400, 1946. (b) Bradley, S. E., and Bradley, G. P.: Renal function during chronic anemia in man, Blood 2: 192-202, 1947. (c) Aas, K., and Blegen, E.: The renal blood flow and the glomerular filtration rate in congestive heart failure and some other clinical conditions. The effect of exercise and hypoxemia. A preliminary report, Scandinav. J. Clin. and Lab. Investigation 1: 22-32, 1949. CrossrefGoogle Scholar25. MokotoffRossLeiter RGL(a) : Renal plasma flow and sodium reabsorption and excretion in congestive heart failure, J. Clin. Investigation 27: 1-9, 1948. (b) Maxwell, M. H., Breed, E. S., and Schwartz, I. L.: Renal venous pressure in chronic congestive heart failure, J. Clin. Investigation 29: 342-348, 1950. CrossrefMedlineGoogle Scholar26. FishmanMaxwellCrowderMorales APMHCHP: Kidney function in cor pulmonale. Particular consideration of changes in renal hemodynamics and sodium excretion during variation in level of oxygenation, Circulation 3: 703-721, 1951. CrossrefMedlineGoogle Scholar27. FarnsworthKrakusin EBJS: Electrolyte partition in patients with edema of various origins. Qualitative and quantitative definitions of cations and anions in cardiac decompensation, J. Lab. and Clin. Med. 33: 1534-1544, 1948. MedlineGoogle Scholar28. WessonAnslowSmith LGWPHW(a) : The excretion of strong electrolytes, Bull. New York Acad. Med. 24: 586-606, 1948. (b) Selkurt, E. E., Hall, P. W., and Spencer, M. P.: Influence of graded arterial pressure decrement on renal clearance of creatinine, p-aminohippurate and sodium, Am. J. Physiol. 159: 369-378, 1949. (c) Weston, R. E., Grossman, J., Escher, D. J. W., Mokotoff, R., and Leiter, L.: Pathogenesis and treatment of salt and water retention in congestive failure, M. Clin. North America 34: 615-628 (May) 1950. (d) Stead, E. A., Jr.: Renal factor in congestive heart failure, Circulation 3: 294-299, 1951. MedlineGoogle Scholar29. BriggsFowellHamiltonRemingtonWheelerWinslow APDMWFJWNCJA(a) : Renal and circulatory factors in the edema formation of congestive heart failure, J. Clin. Investigation 27: 810-817, 1948. (b) Kattus, A. A., Sinclair-Smith, B., Genest, J., and Newman, E. V.: The effect of exercise on the renal mechanism of electrolyte excretion in normal subjects, Bull. Johns Hopkins Hosp. 84: 344-368, 1949. (c) Davis, J. O., and Shock, N. W.: The effect of theophylline ethylene diamine on renal function in control subjects and in patients with congestive heart failure, J. Clin. Investigation 28: 1459-1468, 1949. (d) Newman, E. V.: Function of the kidney and metabolic changes in cardiac failure, Am. J. Med. 7: 490-496, 1949. CrossrefGoogle Scholar30. Dock W: Physiological problems in the treatment of heart failure, J. Mt. Sinai Hosp. 13: 310-317, 1947. MedlineGoogle Scholar31. Hilden T(a) : Glomerular filtration rate and maximal tubular excretory capacity in congestive heart failure, Scandinav. J. Clin. and Lab. Investigation 1: 305-307, 1949. (b) Grossman, J., Weston, R. E., Halperin, J. P., and Leiter, L.: The nature of the renal circulatory changes in chronic congestive failure as reflected by renal tubular maximal functions, J. Clin. Investigation 24: 1320-1326, 1950. CrossrefGoogle Scholar32. BlakeWégriaKeatingWard WDRRPHP: Effect of increased renal venous pressure on renal function, Am. J. Physiol. 157: 1-13, 1949. CrossrefMedlineGoogle Scholar33. ThoringtonSchmidt JMCF(a) : A study of urinary output and blood-pressure changes resulting in experimental ascites, Am. J. M. Sc. 165: 880-890, 1923. (b) Bradley, S. E., and Bradley, G. P.: The effect of increased intraabdominal pressure on renal function in man, J. Clin. Investigation 26: 1010-1022, 1947. CrossrefGoogle Scholar34. LandisBrownFauteuxWise EMEMC(a) : Central venous pressure in relation to cardiac "competence," blood volume and exercise, J. Clin. Investigation 25: 237-255, 1946. (b) Bradley, S. E., and Blake, W. D.: Pathogenesis of renal dysfunction during congestive heart failure, Am. J. Med. 6: 470-480, 1949. (c) Earle, D. P., Jr., Farber, S. J., Alexander, J. D., and Eichna, L. W.: Effect of treatment on renal functions and electrolyte excretion in congestive heart failure, J. Clin. Investigation 28: 778, 1949. (d) Maxwell, M. H., Breed, E. S., and Schwartz, I. L.: Renal venous pressure in chronic congestive heart failure, J. Clin. Investigation 29: 342-348, 1950. CrossrefGoogle Scholar35. HwangAkmanMillerSilberStamlerKatz WLAEJLN: Effect of sustained elevation of renal venous pressure on sodium excretion in the unanesthetized dog, Federation Proc. 9: 65, 1950. Google Scholar36. Merrill AJ(a) : Mechanisms of salt and water retention in heart failure, Am. J. Med. 6: 357-367, 1949. (b) Lasche, E. M., Perloff, W. H., and Durant, T. M.: Some aspects of adrenocortical function in cardiac decompensation, Am. J. M. Sc. 222: 459-467, 1951. (c) Albert, R. E., and Smith, W. W.: Hemodynamic effects of ACTH, DCA and cortisone compared with congestive heart failure, Am. J. Med. 12: 111, 1952. CrossrefMedlineGoogle Scholar37. MerrillMorrisonBrannon AJJLES: Concentration of renin in renal venous blood in patients with chronic heart failure, Am. J. Med. 1: 468-472, 1946. CrossrefMedlineGoogle Scholar38. MokotoffEscherEdelmanGrossmanLeiterWestonZweifachShorr RDJISJLREBWE: Studies on vasotropic principles in blood (VEM and VDM) and renal hemodynamics in chronic heart failure, Federation Proc. 8: 112, 1949. Google Scholar39. Stead EA: Circulatory factors in congestive heart failure, Factors Regulating Blood Pressure, 3rd Conference, May 5-6, 1949, pp. 178-202, Josiah Macy, Jr. Foundation. Google Scholar40. BercuRokawMassie BASNE(a) : Antidiuretic action of the urine of patients in cardiac failure, Circulation 2: 409-413, 1950. (b) Miller, G. E.: Water and electrolyte metabolism in congestive heart failure, Circulation 4: 270-277, 1951. CrossrefMedlineGoogle Scholar41. ThornEmerson GWK(a) : The rôle of gonadal and adrenal cortical hormones in the production of edema, Ann. Int. Med. 14: 757-769, 1940. (b) Sherer, M. G., and Greer, W. E. R.: Cyclic premenstrual congestive heart failure, New England J. Med. 244: 973-975, 1951. LinkGoogle Scholar42. HarrisonPilcherEwing TRCG(a) : Studies in congestive heart failure. IV. The potassium content of skeletal and cardiac muscle, J. Clin. Investigation 8: 325-335, 1930. (b) Calhoun, J. A., Cullen, G. E., and Harrison, T. R.: Studies in congestive heart failure. VII. The effect of overwork on the potassium content of skeletal muscle, J. Clin. Investigation 9: 405-408, 1930. (c) Cullen, G. E., Wilkins, W., and Harrison, T. R.: Electrolytes in human tissue. II. The electrolyte content of hearts and other tissues from cases with various diseases, J. Biol. Chem. 102: 415-423, 1933. (d) Wilkins, W., and Cullen, G. E.: Electrolytes in human tissue. III. A comparison of normal hearts with hearts showing congestive failure, J. Clin. Investigation 12: 1063-1074, 1933. CrossrefMedlineGoogle Scholar43. CattellGoodell MH(a) : On the mechanism of the action of digitalis glucosides on muscle, Science 86: 106-107, 1937. (b) Wood, E. H., and Moe, G. K.: Studies on the effect of the digitalis glucosides on potassium loss from the heart of the heart lung preparation, Am. J. Physiol. 123: 219-220, 1938. (c) Wedd, A. M.: The influence of digoxin on the potassium content of heart muscle, J. Pharmacol. and Exper. Therap. 65: 268-274, 1939. (d) Hagen, P. S.: The effects of digilanid C in varying dosage upon the potassium and water content of rabbit heart muscle, J. Pharmacol. and Exper. Therap. 67: 50-55, 1939. (e) Boyer, P. K., and Poindexter, C. A.: The influence of digitalis on the electrolyte and water balance of heart muscle, Am. Heart J. 20: 586-591, 1940. CrossrefMedlineGoogle Scholar44. ElkintonWinklerDanowski JRAWTS(a) : Inactive cell base and the measurement of changes in cell water, Yale J. Biol. and Med. 17: 383-393, 1944. (b) Elkinton, J. R., Winkler, A. W., and Danowski, T. S.: Transfers of cell sodium and potassium in experimental and clinical conditions, J. Clin. Investigation 27: 74-81, 1948. (c) Squires, R. D., Crosley, A. P., Jr., and Elkinton, J. R.: The distribution of body fluids in congestive heart failure. III. Exchanges in patients during diuresis, Circulation 4: 868-880, 1951. (d) Elkinton, J. R., Squires, R. D., and Bluemle, L. W., Jr.: The distribution of body fluids in congestive heart failure. IV. Exchanges in patients, refractory to mercurial diuretics, treated with sodium and potassium, Circulation 5: 58-73, 1952. (e) Iseri, L. T., Boyle, A. J., and Myers, G. B.: Water and electrolyte balance during recovery from severe congestive failure on a 50 milligram sodium diet, Am. Heart J. 40: 706-730, 1950. (f) Uhl, H. M. S., Alexander, L. C., McCaughey, R. S., Boyle, A. J., Iseri, L. T., and Myers, G. B.: Fluid and electrolyte balance during recovery from high output heart failure due to beriberi, Am. J. Med. 12: 107, 1952. MedlineGoogle Scholar45. DoleDahlCotziasEderKrebs VPLKGCHAME(a) : Dietary treatment of hypertension. Clinical and metabolic studies of patients on the rice-fruit diet, J. Clin. Investigation 29: 1189-1206, 1950. (b) Dole, V. P., Dahl, L. K., Cotzias, G. C., Dziewiatkowski, D. D., and Harris, C.: Dietary treatment of hypertension. II. Sodium depletion as related to the therapeutic effect, J. Clin. Investigation 30: 584-595, 1951. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Pittsburgh, Pennsylvania*Presented at the Thirty-third Annual Session of the American College of Physicians, Cleveland, Ohio, April 23, 1952.From the Department of Research Medicine, and the Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine. Nextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited bySarcolemmal and Sarcoplasmic Reticular ATPase Activities in the Falling Canine HeartTherapie der HerzinsuffizienzThe alkali metal ions in the organismStörungen des Kaliumstoffwechsels und ihre klinische Bedeutung 1 September 1952Volume 37, Issue 3Page: 453-464KeywordsChildrenDietEdemaEndocrine systemHospital medicineRenal circulationSaltsSodium chloride ePublished: 1 December 2008 Issue Published: 1 September 1952 Copyright & PermissionsCopyright, 1952, by The American College of PhysiciansPDF downloadLoading ...

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