Summary
In 11 healthy subjects, in 9 patients with cardiac failure in whom the cardiac index was greater than 2.01/min/m2, and in 7 patients in whom the cardiac index was less than 2.01/min/m2, the blood flow of the forearm and the relationship between the cardiac index and the blood flow of the forearm have been studied. In 6 healthy subjects and 8 patients with heart failure the influence of the intraarterial infusion of Pronethalol, and in 6 patients with cardiac failure the intraarterial infusion of atropin on the blood flow of the forearm was studied.
In the group of patients in whom the cardiac index was higher than 2.0 ml/min/m2 the blood flow in the forearm was the same as in the control group, though the cardiac index was decreased. In the group with cardiac index less than 2.0 1/min/m2 there was a decrease of the blood flow of the forearm.
Intraarterial infusion of Pronethalol in healthy subjects was without effect on the circulation of the forearm. In patients with cardiac failure in whom the blood flow through the forearm was higher, pronethalol decreased the forearm circulation. The administration of atropin in patients with heart failure was without effect on the circulation of the forearm.
Zusammenfassung
Bei 11 kardial gesunden Personen, weiters bei 9 kardial dekompensierten Patienten, bei denen der Herzindex größer als 2,0 1/min/m2 war, sowie bei 7 Patienten, bei denen der Herzindex kleiner als 2,0 1/min/m2 war, untersuchten wir die Beziehung zwischen der Durchblutung des Unterarmes und dem Herzindex. Bei 6 kardial gesunden Personen und bei 8 kardial dekompensierten Patienten verfolgten wir den Einfluß einer intraarteriellen Infusion von Pronethalol auf die Durchblutung des Unterarmes. Bei 6 kardial dekompensierten Patienten analysierten wir den Einfluß einer intraarteriellen Infusion von Atropin auf die Durchblutung des Unterarmes.
In der Gruppe der kardial dekompensierten Patienten mit größerem Herzindex als 2,0 1/min/m2 war die Durchblutung des Unterarmes derselbe wie in der Kontrollgruppe. Bei Patienten mit kleinerem Herzindex als 2,0 1/min/m2 fanden wir eine verminderte Durchblutung des Unterarmes.
Eine intraarterielle Infusion von Pronethalol bei gesunden Personen beeinflußte die Zirkulation des Unterarmes nicht. Bei kardial dekompensierten Patienten, bei denen die Durchblutung des Unterarmes erhöht war, bewirkte eine Infusion von Pronethalol eine Verminderung. Die Applikation von Atropin bei herzdekompensierten Patienten war ohne Einfluß auf die Unterarmdurchblutung.
Similar content being viewed by others
References
Abramson, D. I., S. M. Fierst, andK. Flachs: Effects of muscular exercise upon the peripheral circulation in patients with valvular heart disease. J. clin. Invest.21, 747 (1942).
Barcroft, H., andH. J. C. Swan: Sympathetic control of human blood vessels. London: Arnold 1953.
Blair, D. A., W. E. Glover, A. D. M. Greenfield, andI. C. Roddie: Excitation of cholinergic vasodilator nerves to human skeletal muscle during emotional stress. J. Physiol. (Lond.)148, 633 (1959).
Blair, D. A., W. E. Glover, andI. C. Roddie: Vasomotor responses in the human arm during leg exercise. Circulat. Res.9, 264 (1961).
Brod, J., V.Fencl, Z.Hejl, J.Jirka, and M.Ulrych: Muscle blood flow in heart failure. Abstracta IV. Congressus cardiologicus Europaeus, Pragae 1964, p. 47.
Chidsey, C. A., D. C. Harrison, andE. Braunwald: Augmentation of the plasma nor-epinephrine responses to exercise in patients with congestive heart failure. New. Engl. J. Med.267, 650 (1962).
Cohn, A. E., andJ. M. Steele: Unexplained fever in heart failure. J. clin. Invest.13, 853 (1934).
Cooper, K. E., O. G. Edholm, andR. F. Mottram: The blood flow in skin and muscle of the human forearm. J. Physiol. (Lond.)128, 258 (1955).
Folkow, B.: Autoregulation in muscle and skin. Circulat. Res. Suppl. I.,19 (1964).
Howitt, G., J. Tinker, andE. G. Wade: The effect of pronethalol in mitral stenosis. Clin. Sci.28, 417 (1965).
Kettel, L. J., H. W. Overbeck, R. M. Daugherty, J. P. Lillehei, R. F. Coburn, andF. J. Haddy: Responses of the human upper extremity vascular bed to exercise, cold, levarterenol, angiotensin, hypertension, heart failure, and respiratory tract infection with fever. J. clin. Invest.43, 1561 (1964).
Kuschke, H. J.: Untersuchungen über den Erregungszustand des sympathischen Nervensystems und des Nebennierenmarkes bei kardiovaskulären Erkrankungen. Arch. Kreisl.-Forsch.36, 104 (1961).
Landt, H., andJ. E. Benjamin: Changes in the content of carbon dioxide in venous blood during rebreathing experiments. Comparison of change in persons with a normal heart and in patients with cardiac disease. Arch. intern. Med.67, 72 (1941).
Linhart, J., and I.Přerovsky: Praha: Thomayerová sbírka 1958.
Lowe, R. D., andB. F. Robinson: Effect of differential adrenergic blockade on response of forearm blood flow to infused catecholamines. Clin. Sci.26, 81 (1964).
Mason, D. T., andE. Braunwald: Studies on digitalis X. Effect of Ouabain on forearm vascular resistance and venous tone in normal subjects and in patients in heart failure. J. clin. Invest.43, 532 (1964).
McMichael, J., andE. P. Sharpey-Scafer: The action of intravenous digosin in man. Quart. J. Med.13 123 (1944).
Munth, H. A. V., P. N. Wormald J. M. Bishop andK. W. Donald: Further studies of blood flow in the resting arm during leg exercise. Clin. Sci.17 603 (1958).
Pekkarinen, A., E. Iisalo, A. Kasanen B. Laihinen, andB. Thomason: The adrenosympathetic and adrenocortical function in cardiac insufficiency. Amer. J. Cardiol.5 604 (1960).
Rodbard, S.: Evidence that vascular conductance is regulated at the capillary. Hypertension13, 160 (1965).
Roddie, I. C.: andJ. T. Shepherd: The reflex nervous control of human skeletal muscle blood vessels. Clin. Sci.15, 433 (1956).
— — andR. F. Whelan: The contribution of constrictor and dilator nerves to the skin vasodilatation during body heating. J. Physiol. (Lond.)136, 489 (1957).
— — —: Reflex changes in vasoconstrictor tone in human skeletal muscle in response to stimulation of receptors in the low-pressure area of the intrathoracic vascular bed. J. Physiol. (Lond.)139, 369 (1957).
Schreiner jr.,B. P., T. Lovejoy, andP. N. Yu: Estimation of cardiac output from precordial dilution curves in patients with cardiopulmonary disease. Circulat. Res.7, 595 (1959).
Schweitzer, P., andM. Torma: Oxygen consumption and blood flow in the muscle of the forearm in patients with cardiac failure. Clin. Sci.25 493 (1963).
Scott, R. W.: The total carbonate content of the arterial and venous plasma in patients with chronic heart disease. Proc. Soc. exp. Biol. (N.Y.)17, 19 (1919).
Sharpey-Schafer, E. P.: Venous tone: effects of reflex changes, humoral agents and exercise. Brit. med. Bull.19, 145 (1963).
Stewart, H. J., W. F. Evans, H. Brown, andJ. R. Gerjuoy: Peripheral blood flow, rectal and skin temperature in congestive heart failure. The effects of rapid digitalisation in this state. Arch. intern. Med.77, 643 (1946).
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Schweitzer, P., Pivoňka, M. & Klvaňová, H. The blood flow in the forearm in patients with cardiac failure. Z. Gesamte Exp. Med. 143, 126–135 (1967). https://doi.org/10.1007/BF02042880
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF02042880