THE INCREASED PLASMA VOLUME IN CARDIAC INSUFFICIENCY: ITS CORRELATION WITH RIGHT-SIDED FAILURE

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Abstract
There is an increase in the circulating plasma vol. in cardiac insufficiency, but its mechanism remains obscure. Data was secured on 8 patients with acute right-sided and 8 with acute left-sided heart failure. The results indicate that the patients with right-sided cardiac insufficiency exhibited a greater increase in plasma vol. than did those with left. The rise was generally related to the degree of liver enlargement, but only a rough parallelism was observed between the plasma v 1. and such measurements as venous pressure, circulation time and vital capacity. These observations suggest that the liver and possibly the entire portal circulation react to increases in hepatic vein pressure by dilatation and an enlarged venous bed. Peripheral veins, on the other hand, appear to respond to the same pressure stimulus primarily by a rise in pressure and with less change in vol. A mechanism such as this may be at least a partial factor to account for the increased plasma vol. in cardiac insufficiency.