Production of Chronic Elevation of Left Ventricular End Diastolic Pressure in Dogs: Hemodynamic and Renal Studies
In an effort to produce a preparation for the study of sodium excretion in chronic left heart failure a graft anastomosis was created between the left subclavian artery and the left atrium in five dogs. This resulted in chronic progressive elevation of left ventricular end diastolic and left atrial pressures. Maximal left ventricular end diastolic pressures ranged between 18 and 30 mm Hg, 10 to 20 weeks postoperatively. There was only a slight rise in right ventricular diastolic pressure and no clinical evidence of right heart failure.
Cardiac outputs remained within normal limits in all animals. Serial electrocardiograms disclosed the development of left ventricular hypertrophy and left ventricular hypertrophy and dilatation were observed at postmortem examination. One dog which survived with a patent shunt for more than a year had right as well as left ventricular hypertrophy but no right heart failure. Glomerular filtration rates, renal plasma flow and excretion of rapidly infused isotonic saline remained unaltered even at the highest levels of left ventricular end diastolic pressure. Although the development of left and eventually right ventricular hypertrophy, the chronic and progressive elevation of left ventricular end diastolic, mean left atrial and pulmonary arterial pressure, with only slight elevation of right ventricular end diastolic pressure, were regarded as characteristic features of isolated left ventricular failure, the propriety of this term may be questioned in view of the unaltered cardiac output and renal hemodynamics. But the observations do indicate that marked elevation of left ventricular end diastolic and presumably pulmonary venocapillary pressure, such as occur in left heart failure, do not impair renal excretion of sodium.
- Received December 9, 1963.
- © 1964 American Heart Association, Inc.