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[The early hemodynamic and hormonal changes in patients with left ventricular dysfunction].

C Tritto1, M Volpe, G Lembo

  • 1Istituto di I Clinica Medica, II Facoltà di Medicina e Chirurgia, Università degli Studi, Napoli.

Cardiologia (Rome, Italy)
|February 1, 1991
PubMed
Summary

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Patients with early heart failure show altered hormonal and hemodynamic responses to salt/volume loading. These early changes in cardiac function may predict disease progression and guide early therapeutic interventions.

Area of Science:

  • Cardiology
  • Endocrinology
  • Nephrology

Background:

  • Mild cardiomyopathy, including early stages of congestive heart failure (CHF), presents unique physiological challenges.
  • Understanding hormonal and hemodynamic profiles in early CHF is crucial for timely intervention.

Purpose of the Study:

  • To identify distinct hormonal and hemodynamic patterns in patients with mild cardiomyopathy (NYHA class I and II).
  • To compare the responses to isotonic saline load (SL) between patients with mild CHF and healthy controls.

Main Methods:

  • Subjects with mild CHF (post-ischemic and idiopathic) and age/sex-matched controls underwent a controlled isotonic saline load.
  • Hormonal (atrial natriuretic factor, plasma renin activity, plasma aldosterone) and hemodynamic (ejection fraction, cardiac output, peripheral resistance) parameters were measured.

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Main Results:

  • Basal differences between groups included atrial natriuretic factor, left ventricular end-diastolic diameter, and ejection fraction.
  • After SL, controls showed significantly higher increases in ejection fraction, cardiac output, and atrial natriuretic factor compared to CHF patients.
  • Peripheral resistance increased only in CHF patients, and the reduction in plasma renin activity and aldosterone was blunted in CHF.

Conclusions:

  • Hormonal, renal, and hemodynamic responses to salt/volume loading are impaired in the early, asymptomatic phase of heart failure.
  • These early abnormalities can predict further cardiac function deterioration and inform early therapeutic strategies.