Untreated Congestive Heart Failure Studies of Mechanisms
The mechanisms involved in the accumulation of salt and water in patients with congestive heart failure (CHF) have remained somewhat elusive. There is considerable evidence that neurohormonal responses are altered in patients with heart failure and that some of the alterations may be responsible for this syndrome. 1–4 But the problem with most of the reported studies is that they were made on patients who had received some form of treatment. Treatment in general, and diuretic treatment in particular, has profound effects on hormone levels making it difficult to distinguish between changes induced by disease and those by drug therapy. 1,2,5–7 In some investigations, attempts have been made to examine the syndrome by studying patients from whom drug therapy has been withdrawn for a short duration. Nevertheless, in treated patients one can never be certain as to whether the specific results obtained are attributable to therapy or to the evolution of CHF, or both. There is, therefore, need for data on patients of established CHF who have never received any drug therapy.
KeywordsCongestive Heart Failure Atrial Natriuretic Peptide Plasma Renin Activity Total Body Water Systemic Arterial Pressure
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