Emmett S. Brannon

Concentration of renin in renal venous blood in patients with chronic heart failure

Abstract 1.1. Renal venous blood was obtained from five normal subjects and eleven patients with fixed chronic congestive failure. A catheter introduced into the antecubital vein was threaded through the venous system into the renal vein. Dogs were used for the assay of renin. 2.2. No renin was detected in the renal venous blood or arterial blood of the normal subjects. It is to be noted that the dog is only about one-fourth as sensitive to renin as the cat. 3.3. Significant amounts of renin were found in the renal venous blood of eight of the eleven patients with chronic heart failure. No renin was detected in the arterial blood. 4.4. The finding of increased concentration of renin in the renal venous blood of patients with chronic congestive failure is additional evidence in support of the finding that the renal blood flow is greatly reduced in chronic heart failure. 5.5. The well maintained blood pressure in the presence of a low cardiac output, the sudden changes in venous pressure produced by relieving pericardial tamponade and by improvement of the circulation by digitalis, and the marked fall in renal blood flow out of proportion to the fall in cardiac output all suggest that active vasoconstriction is present in patients with heart failure. No final conclusion can be reached at this time as to whether renin is responsible for some of the observed vasoconstriction. ∗ ∗The hypertensin used for renin standardization was furnished through the courtesy of Dr. K. G. Kohlstaedt, of the Lilly Research Laboratory.

Effect of increasing the blood volume and right atrial pressure on the circulation of normal subjects by intravenous infusions

M ANY observations on the effects of decreasing the blood volume in man have been reported, but much less information is available on the effects of increasing the blood volume. It is known that an increase in blood volume caused by the rapid intravenous administration of fluid will produce a rise in venous pressure. The effects of this rise in venous pressure on the cardiac output and the size of the heart are of considerable importance to the physician. If, as the venous pressure rises, the normal heart is dilated and the cardiac output greatly increased, this would indicate that a considerable strain was being placed upon the heart. Such a reaction might explain the poor tolerance of patients with heart failure to intravenous fluids.

A Method of Obtaining Blood Samples Directly from the Hepatic Vein in Man

Summary A method is described for obtaining samples of blood from the hepatic vein in man by means of a catheter in the venous system. Only a moderate amount of skill is required, and if carried out with care, samples can be obtained with minimal discomfort and danger to the subject.

Pericardial tamponade from stab wound of the heart and pericardial effusion or empyema: A study utilizing the method of right heart catheterization

Abstract Patients with penetrating wounds of the heart with pericardial tamponade often present the clinical picture of profound shock. Study of these patients demonstrates the presence of a significantly different hemodynamic situation from that occurring in patients with shock produced by hemorrhage or by stab wounds of the chest. Observations on the changes in the circulation in seven patients with pericardial tamponade from stab wounds of the heart or from infection of the pericardium form the basis for this report.

Hemodynamics of acute hemorrhage in man

Abstract The adjustments of the circulation to acute hemorrhage have been extensively studied in experimental animals. A complete hemodynamic study of the effects of acute hemorrhage in man has been difficult because of the lack of a method for measuring the cardiac output and the right atrial pressure in acutely ill patients. The development of the technique of right atrial catheterization, as described by Cournand and Ranges, 1 made clinical studies of acute hemorrhage possible. The purpose of this paper is to describe the hemodynamics in thirteen patients with acute blood loss.