Interstitial colloid osmotic and hydrostatic pressures in human subcutaneous tissue during early stages of heart failure

Publisher Website
Google Scholar
Abstract
Subcutaneous edema is a common finding in heart failure. Some patients have reduced cardiac pump function without edema. Whether local mechanisms in s.c. tissue contribute to edema prevention was investigated. A reduction in interstitial colloid osmotic pressure (.pi.i) and a rise in interstitial fluid hydrostatic pressure (Pi) will both counteract a rise in capillary filtration caused by heart failure. Cardiac catheterization was done in 22 angina pectoris patients without visible edema. Two days later .pi.i was measured with a wick method and Pi was measured with a wick-in-needle method. Both parameters were measured in s.c. tissue on thorax at heart level and on the ankle. Plasma volume was determined by 125I-albumin and extracellular volume measured with 35SO4. Parameters of cardiac pump function ranged from normal to clearly pathological values. Mean .pi.i was 13.0 mm Hg on thorax and 8.3 mm Hg on the ankle. Pi averaged -2.1 mm Hg on thorax and -1.5 mm Hg on the ankle. Statistically significant (P < 0.05) correlations were found between .pi.i on thorax and left ventricular end diastolic pressure (rs -0.40) and .pi.i on thorax and cardiac index (rs 0.42). Pi was positively correlated to right atrial pressure (rs 0.50). Body fluid volumes were normal or moderately reduced. Apparently, a reduction in cardiac pump function is associated with a reduction in .pi.i and a rise Pi. These changes may help prevent edema formation in the early stages of heart failure.