THE RELATIONSHIP OF CARDIOVASCULAR AND RENAL HEMODYNAMIC FUNCTION TO SODIUM EXCRETION IN PATIENTS WITH SEVERE HEART DISEASE BUT WITHOUT EDEMA 12

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Abstract
Cardiac patients who had many clinical and hemodynamic findings of congestive heart failure but no history of peripheral edema were found to tolerate a moderately high Na intake without developing edema or salt retention. Many in the group likewise showed no impairment in Na excretion when infused with 5% saline. The most consistent hemodynamic measurement that differentiated this group from a similar cardiac group with peripheral edema was the finding of a lower right ventricular end-diastolic pressure. The finding supports the concept that Na retention in congestive heart failure may be initiated primarily by a critical rise in the venous pressure rather than by a decrease in cardiac output or glomerular filtration rate.