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Significance of peripheral edema on increased venous tone in congestive heart failure Muneyasu Saito 1 , Tetsuya Sumiyoshi 1 , Youichi Goto 1 , Katsuhiko Hiramori 1 1Cardiology Division, Department of Internal Medicine, National Cardiovascular Center pp.51-58
Published Date 1987/1/15
DOI https://doi.org/10.11477/mf.1404204989
  • Abstract
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It has been accepted that peripheral vasomotor tone is increased in patients with congestive heart failure (CHF) probably due to two basic mechanisms ; incre-ased sympatho-adrenergic activity and increased vascular stiffness. Although these two mechanisms has their roles on increased venous tone in CHF, an important role of peripheral edema has recently been suggested. Therefore, we measured central and peripheral hemodynamics using Swan-Ganz catheter and occlusion plethysmogra-phy in 17 patients before and after treatment of their CHF, which were classified into two groups ; acute left heart failure (n=8) and chronic bilateral heart failure (n=9). Venous tone was represented by VV30, the increase in calf volume at occlusion pressure of 30mmHg, as well as slope (b) and intercept (a) obtained from exponential approximation of venous pressure-volume relationship.

When peripheral hemodynamic parameters were com-pared with central hemodynamics, calf blood flow (CBF) and calf vascular resistance (CVR) significantly correlated with cardiac index and total systemic resi-stance, respectively. VV30 and intercept (a) correlated with right atrial pressure r=-0.80 and 0.80, respectively), indicating that peripheral venous tone is largely dependent on venous pressure itself. After treat-ment of CHF, filling pressure of right and left ventricle decreased, VV30 increased and intercept (a) decreasedsignificantly; the extent of those peripheral hemody-namic changes were more in bilateral heart failure compared to acute left heart failure. VV30 also signi-ficantly correlated with the decrease in body weight and sum of water balance during the treatment of CHF.

These results indicate that peripheral edema plays an important role in the genesis of increased venous tone in congestive heart failure.


Copyright © 1987, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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