MYOCARDIAL POTASSIUM AND SODIUM METABOLISM IN VARIOUS CARDIAC DISORDERS, AND THE RELATIONSHIP BETWEEN POTASSIUM AND DIGITALIS TOLERANCE
1957 Volume 46 Issue 9 Pages 1080-1089
Details
1957 Volume 46 Issue 9 Pages 1080-1089
Myocardial potassium and sodium metabolism was studied by means of coronary sinus catheterization in the material of 58 cases in cluding 11 cases of normal control, 25 cases of congestive heart failure of valvular or hypertensive origin, 6 cases of hypertension, 6 cases of coronary sclerosis, 5 cases of hyperthyroidism, 4 cases of anemia and 1 case of beri-beri.
In addition, the relationship between plasma potassium concentration and digitalis tolerance was investigated in 27 cases of congestive heart failure under digitalis maintenance.
1) In the resting condition, no significant coronary arteriovenous potassium or sodium difference was observed in the group of congestive heart failure as well as in normal subjects. In two of six cases of congestive heart failure, the potassium leakage was noted upon excercise load. Some discussions were made in this regard with reference to the pertinent literature.
2) The obvious trend of potassium leakage due to exercise load was noted among cases of hyperthyroidism.
3) The above-mentioned finding of potassium loss was similar to what was observed in cases of hypertension following the injection of adrenalin. Some discussions were given about these points.
4) In one case of advanced coronary sclerosis, the exercise load resulted in the massive loss of myocardial potassium, whereas in another in which the hypoxic load provoked the anginal attack, the potassium intake was observed unexpectedly. The discussions were also made concerning these apparently conflicting findings.
5) Cardiac glycosides produced no definite effects upon myocardial potassium or sodium balance in cases of congestive failure.
6) As to theophylline-ethylendiamine, also ro specific action was noted regarding myocardial potassium or sodium metabolism.
7) In one case of beri-beri, myocardial uptake of potassium, simultaneous with the clinical improvement, was noted following the injection of large dose of thiamine.
8) The correlation between plasma potassium concentration and digitalis tolerance was demonstrated in the group of congestive heart failure
