Experimentally Induced Hypervolemia During Ganglionic Blockade: The Effect on Cardiac Functios in Patients with Mitral Disease

Abstract

The hemodynamic effects of hypervolemia, induced by dextran infusion during simultaneous ganglionic blockade with arfonad, have been investigated in 13 patients with mitral disease.

In Series I (5 patients), where dextran infusion was started before the ganglionic blockade, arfonad caused a decrease in blood pressures, but cardiac output remained unaltered. This could possibly be clue to dextran continuously sustaining the filling d the heart.

In Series II (8 patients), where ganglionic blockade preceded the dextran infusion, the hypervolemia caused a rise of right atrial and pulmonary arterial blood pressures toward or above the basal values. Cardiac output and stroke volume increased. There was a good correlation between right ventricular stroke work index and mean right atrial pressure during the autonomic blocking with arfonad. No such correlation could be found when the basal values were compared to the last values without autonomic blocking.

It is concluded that other factors than the filling pressure govern the cardiac output and work of the heart, as long as myocardial failure has not supervened.