抄録
For the water-balance across the capillary walls Starling's hypothesis has been widely accepted. Hayase and his coworkers reported that the osmolal arteriovenous difference (referred to hereafter as osmolal A-V difference) in the limbs of patients with congestive heart failure was often negative and that the venous pressure showed a rough negative correlation with osmolal A-V difference. In order to clarify the mechanisms underlying this phenomenon, the present author carried out a series of animal experiments where a balloon was inflated at various parts of the systemic or pulmonary venous system in dogs to increase the venous pressure of the up-stream regions. During the systemic venous congestion, the osmolal A-V difference shifted towards the negative side locally; in the case of the pulmonary venous congestion, the systemic osmolal A-V difference tended to shift towards the positive side. The negative shift of osmolal A-V difference caused by the elevation of the systemic venous pressure was inhibited by the pre-treatment with pentolinium or reserpine but it was not influenced by atropine or vagotomy. Therefore, the phenomenon in question appears to be related to the sympathetic nervous system. There are evidences indicating that the substance(s), responsible for the observed shift in osmolal A-V difference was mainly sodium. The results shown in the present paper suggest that the increase in venous pressure is associated with a certain change in the capillary exchange of the peripheral circulation.
