Hormonal and Cardiorenal Responses to Acute Saline Loading in Mild Congestive Heart Failure The Effect of Angiotensin Converting Enzyme Inhibition

Hirofumi Tomiyama; Eisuke Nishikawa; Gohki Watanabe; Koichiro Shiojima; Kazuhiro Shimada; Akira Yamarnoto; Yasuro Ishikawa; Hideo Yoshida; Nobutaka Doba

doi:10.1253/jcj.62.29

Clinical Study

Hormonal and Cardiorenal Responses to Acute Saline Loading in Mild Congestive Heart Failure

The Effect of Angiotensin Converting Enzyme Inhibition

Hirofumi Tomiyama, Eisuke Nishikawa, Gohki Watanabe, Koichiro Shiojima, Kazuhiro Shimada, Akira Yamarnoto, Yasuro Ishikawa, Hideo Yoshida, Nobutaka Doba

Author information

Hirofumi Tomiyama
Division of Cardiology, The Third Department of Internal Medicine, Teikyo University School of Medicine, Ichihara Hospital
Eisuke Nishikawa
Division of Cardiology, The Third Department of Internal Medicine, Teikyo University School of Medicine, Ichihara Hospital
Gohki Watanabe
Division of Cardiology, The Third Department of Internal Medicine, Teikyo University School of Medicine, Ichihara Hospital
Koichiro Shiojima
Division of Cardiology, The Third Department of Internal Medicine, Teikyo University School of Medicine, Ichihara Hospital
Kazuhiro Shimada
Division of Cardiology, The Third Department of Internal Medicine, Teikyo University School of Medicine, Ichihara Hospital
Akira Yamarnoto
Division of Cardiology, The Third Department of Internal Medicine, Teikyo University School of Medicine, Ichihara Hospital
Yasuro Ishikawa
Division of Cardiology, The Third Department of Internal Medicine, Teikyo University School of Medicine, Ichihara Hospital
Hideo Yoshida
Division of Cardiology, The Third Department of Internal Medicine, Teikyo University School of Medicine, Ichihara Hospital
Nobutaka Doba
Division of Cardiology, The Third Department of Internal Medicine, Teikyo University School of Medicine, Ichihara Hospital

Keywords: Mild heart failure, Natriuresis, Angiotensin-converting enzyrne inhibitor, Renin-angiotensin system, Renal function

JOURNAL FREE ACCESS

1998 Volume 62 Issue 1 Pages 29-35

DOI https://doi.org/10.1253/jcj.62.29

Details

Abstract

We investigated cardiorenal responses to acute saline loading in patients with mild congestive heart failure (CHF) with and without angiotensin-converting enzyme (ACE) inhibition. Saline loading (infusion of 250 ml of normal saline) was performed on 10 patients with mild CHF and 10 control subjects. Although saline loading reduced plasma renin activity and plasma angiotensin II to a similar extent in both groups, it increased cardiac output, renal blood flow, and the ratio of renal blood flow to cardiac output in the mild CHF group but not in the control group. After saline loading, urinary sodium excretion was higher in the control than in the mild CHF group. In the mild CHF group, saline loading was performed again after an ACE inhibitor (delapril) had been administered for 5 days. Although delapril increased cardiac output and renal blood flow under basal conditions, saline loading did not affect these variables. Delapril improved urinary sodium excretion after saline loading. Thus, the renin-angiotensin-aldosterone axis may contribute to cardiorenal hemodynamics and renal sodium handling in patients with mild CHF. This effect may attenuate the natriuretic response to acute saline loading, and administration of an ACE inhibitor improves this attenuation. (Jpn Circ J 1998; 62: 29 - 35)

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