BRISKET DISEASE. III. SPONTANEOUS REMISSION OF PULMONARY HYPERTENSION AND RECOVERY FROM HEART FAILURE*

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Abstract
Clinical observations and repeated cardiac catheterization studies carried out in a group of 14 calves with altitude-dependent pulmonary hypertensive heart (brisket) disease have demonstrated spontaneous remission of clinical manifestations and improvement in all measured physiologic abnormalities associated with removal of animals from high altitude ranges (8-11,000 feet) to Salt Lake City (4,500 feet). Average cardiac index increased from 4.9 to 6.1 l/min/m2 (normal 7.2). Average pulmonary artery mean pressure fell from 63 to 32 mm Hg (normal 22). Calculated pulmonary vascular resistance index fell from 12.3 to 3.8 mm Hg/1/min/n2 (normal 2.3). Average right a trial and pulmonary artery wedge mean pressures fell from 21 to 0 and 23 to 12mm Hg (normal 0 and 6), respectively consistent with disappearance of congestive heart failure. The evidence is con-sistent with the interpretation that brisket disease results mainly from hypoxic pulmonary vasoconstriction.