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The mechanism of acute cardiac pulmonary edema
SELECTED
627
ABSTRACTS
Vittorio, Jr., and D’ Agostino, Lorenzo: Pressure Registration by Clinical Methods. III. of Venous Tone. Cardiologia 4: 107, 1940.
Scaffidi,
On the Significance The Neurovegetative
of Venous Regulation
&Simultaneous determination of venous pressure and the caliber of superficial peripheral veins of persons in a recumbent position after the administration of neurovegetative effective substances were studied. Venous hypertension caused by pilocarpine, histamine and ergotamine is accompanied with venous constriction. On the other hand, venous hypotension due to atropine is accompanied with dilatation of the veins. Venous hypertension following the injection of adrenalin often shows a simultaneous dilation of the veins; in other cases no change whatever The action of the first four substances is to be seen in the caliber of the veins. proves that chemical excitation of the parasympathicus causes venous constriction and hypertension; wherefore, one is led to the conclusion that the vagus is the There cause of the constriction of the veins in opposition to the sympathicus. is then a regulatory mechanism for venous circulation by means of changes in The venous circulation, as regards its the tonus of the walls of the veins. teleologic effect, is in harmonious combination with the neurovegetative regulati.on of the arterial tonus. The hypertension subsequent to the administration of adrenalin, which is not in accord with the conclusions mentioned above, is to be looked upon as .a direc.t musc,le effect of the substance of the wall of the vein; the dilatation of the veins observed is to be interpreted as a mobilization of the blood from the depots and, therefore, an increase of the circulating blood. AUTHORS. Von
A. Huttmann, on Heart Stroke
and
Eiser,
Prequency.
A.:
On the Cardiologia
Interpretation 3: 371, 1940.
The duration of systole and diastole at a heart rate of measured in 230 normal subjects. The figure, at increasing diminution which follows definite rules. Aside from Basett’s systolic index, a normal diastolic observed. The relationship between duration of diastole and examined. The minute systoles and minute diastoles were the duration of systole and that of the diastole by figures for the various rates of the heart are given.
of Heart
Action
45 to 135 per frequencies, index
Phases
minute was showed a
of 0.56 to 0.62 was
duration of systole was obtained by multiplying Sormal the frequency. AUTHORS.
Wassermann,
ologia
S. :
3: 402,
The 1940.
Mechanism
of
Acute
Cardiac
Pulmonary
Edema.
Cardi-
a case is reported suffering from cardiac pulmonary edema; electrocardiograms were taken during the attack and during a therapeutically successful carotid sinus pressure experiment. The records obtained during the attack and during the pressure on the carotid sinus are not different from the resting electrocardiograms with regard to rate, rhythm, and conductivity. The record taken during the attack shows a diminution of R, and R, (hypotonia of the cardiac muscle?); this diminution of the R wave disappeared during the carotid sinus pressure experiment. The attacks are attributed to an insufficiency of the pressoreceptor mechanism; th.is explains the succe.ss of the carotid sinus pressure. Carotid sinus pressure produced in this and similar cases only a negligible diminution of heart rate (by approximately ten per minute) ; this is of evidence for the view that carotid sinus pressure in attacks of cardiac pulmonary edema is beneficial through the vascular, and not through the cardiac carotid sinus
628
THE
AMERICAN
HEART
JOURNAL
reflex. The dyspnea during pulmonary edema is further attributed to pressoreceptor insufficiency and not to pulmonary congestion; similarly, the origin of the alveolar edema is not explained as a sign of congestion, but as a consequence of redex vasopulmonary phenomena (vasospasm, or -paralysis, increases capillary permeability?). This explains the possibility of stopping the attacks (spontaneous improvement; action of morphine or of carotid sinus pressure). AUTO-10~.
Herrington, L. P.: The Heat Environmental Temperatures.
Regulation of Small Laboratory Animals Am. J. Physiol. 129: 123, 1940.
at Various
An extensive study of the metabolism of guinea pigs, rats, and mice has identified a region of thermal neutrality at 30 to 31” for the guinea pig, 28 to 29” for the rat, and between 30” and 33” for the mouse. Metabolisms of the order of 590, 680, and 740 calories per square meter per 24 hours, in the same species order, are typical of these temperature ranges. Above this critical area, the metabolism under hot conditions is very variable, due possibly to the lack of a true physiologic regulation by evaporation. All three species make an effort at adaptation through spreading saliva on their coats, but the success of this process is highly variable. It has been shown that the metabolic increment with decrease in environmental temperature is species-specific and highly regular. The value of this increment, however, is not in 1:l correlation with susceptibility to heat 10,s~ as judged by surface-weight ratios, and re5eets differences in peripheral insulation and probably in response adequacy. Chemical regulation in these animals is not as completely effective as has been thought. It appears that in spite of large increases in metabolism, the average body temperature fall,s with decreasing environmental temperature in much the same manner as has been observed in larger animals which do not show chemical regulation in this range. This fall in average body temperature produces failure of regulation when the physiologic limit of storage is reached. Values are given for surface temperatures in conjunction with known levels From these values the of rectal temperature, air temperature, and metabolism. various conductances, including the environmental heat loss constants, have been computed. Derived values for average body temperature are presented as an illustration of the gradual failure of heat regulation in progressively colder environments. Theoretical considerations are presented in regard to the practical limit of chemical regulation which suggest that such a limit is not entirely dependent upon the reserve of heat-producing capacity. AUTHOR.
Seltzer, cise.
Carl Am.
C.: Body J. Physiol.
Build 129:
and Oxygen 1, 1940.
Metabolism
at Rest
and
During
Exer-
The rssults of this investigation with respect to the interrelation of body build and oxygen metabolism may be summarized as follows: There appears to be a relation of a constitutional nature between morphology of individuals and their consumption of oxygen. The more “linear” individuals and those with relatively shorter upper and 5atter chest outlines, and with narrower hips lower extremities, longer torsos, relative to breadth of shoulders have higher oxygen intakes in the resting ,&ate than their “lateral” counterparts. This appears to be the case irrespective of whether the oxygen consumption is related to body weight or surface area. With respect to moderate exercise smaller oxygen intakes per kilo of body weight are displayed by individuals who are more “lateral” than “linear. ”
627
ABSTRACTS
Vittorio, Jr., and D’ Agostino, Lorenzo: Pressure Registration by Clinical Methods. III. of Venous Tone. Cardiologia 4: 107, 1940.
Scaffidi,
On the Significance The Neurovegetative
of Venous Regulation
&Simultaneous determination of venous pressure and the caliber of superficial peripheral veins of persons in a recumbent position after the administration of neurovegetative effective substances were studied. Venous hypertension caused by pilocarpine, histamine and ergotamine is accompanied with venous constriction. On the other hand, venous hypotension due to atropine is accompanied with dilatation of the veins. Venous hypertension following the injection of adrenalin often shows a simultaneous dilation of the veins; in other cases no change whatever The action of the first four substances is to be seen in the caliber of the veins. proves that chemical excitation of the parasympathicus causes venous constriction and hypertension; wherefore, one is led to the conclusion that the vagus is the There cause of the constriction of the veins in opposition to the sympathicus. is then a regulatory mechanism for venous circulation by means of changes in The venous circulation, as regards its the tonus of the walls of the veins. teleologic effect, is in harmonious combination with the neurovegetative regulati.on of the arterial tonus. The hypertension subsequent to the administration of adrenalin, which is not in accord with the conclusions mentioned above, is to be looked upon as .a direc.t musc,le effect of the substance of the wall of the vein; the dilatation of the veins observed is to be interpreted as a mobilization of the blood from the depots and, therefore, an increase of the circulating blood. AUTHORS. Von
A. Huttmann, on Heart Stroke
and
Eiser,
Prequency.
A.:
On the Cardiologia
Interpretation 3: 371, 1940.
The duration of systole and diastole at a heart rate of measured in 230 normal subjects. The figure, at increasing diminution which follows definite rules. Aside from Basett’s systolic index, a normal diastolic observed. The relationship between duration of diastole and examined. The minute systoles and minute diastoles were the duration of systole and that of the diastole by figures for the various rates of the heart are given.
of Heart
Action
45 to 135 per frequencies, index
Phases
minute was showed a
of 0.56 to 0.62 was
duration of systole was obtained by multiplying Sormal the frequency. AUTHORS.
Wassermann,
ologia
S. :
3: 402,
The 1940.
Mechanism
of
Acute
Cardiac
Pulmonary
Edema.
Cardi-
a case is reported suffering from cardiac pulmonary edema; electrocardiograms were taken during the attack and during a therapeutically successful carotid sinus pressure experiment. The records obtained during the attack and during the pressure on the carotid sinus are not different from the resting electrocardiograms with regard to rate, rhythm, and conductivity. The record taken during the attack shows a diminution of R, and R, (hypotonia of the cardiac muscle?); this diminution of the R wave disappeared during the carotid sinus pressure experiment. The attacks are attributed to an insufficiency of the pressoreceptor mechanism; th.is explains the succe.ss of the carotid sinus pressure. Carotid sinus pressure produced in this and similar cases only a negligible diminution of heart rate (by approximately ten per minute) ; this is of evidence for the view that carotid sinus pressure in attacks of cardiac pulmonary edema is beneficial through the vascular, and not through the cardiac carotid sinus
628
THE
AMERICAN
HEART
JOURNAL
reflex. The dyspnea during pulmonary edema is further attributed to pressoreceptor insufficiency and not to pulmonary congestion; similarly, the origin of the alveolar edema is not explained as a sign of congestion, but as a consequence of redex vasopulmonary phenomena (vasospasm, or -paralysis, increases capillary permeability?). This explains the possibility of stopping the attacks (spontaneous improvement; action of morphine or of carotid sinus pressure). AUTO-10~.
Herrington, L. P.: The Heat Environmental Temperatures.
Regulation of Small Laboratory Animals Am. J. Physiol. 129: 123, 1940.
at Various
An extensive study of the metabolism of guinea pigs, rats, and mice has identified a region of thermal neutrality at 30 to 31” for the guinea pig, 28 to 29” for the rat, and between 30” and 33” for the mouse. Metabolisms of the order of 590, 680, and 740 calories per square meter per 24 hours, in the same species order, are typical of these temperature ranges. Above this critical area, the metabolism under hot conditions is very variable, due possibly to the lack of a true physiologic regulation by evaporation. All three species make an effort at adaptation through spreading saliva on their coats, but the success of this process is highly variable. It has been shown that the metabolic increment with decrease in environmental temperature is species-specific and highly regular. The value of this increment, however, is not in 1:l correlation with susceptibility to heat 10,s~ as judged by surface-weight ratios, and re5eets differences in peripheral insulation and probably in response adequacy. Chemical regulation in these animals is not as completely effective as has been thought. It appears that in spite of large increases in metabolism, the average body temperature fall,s with decreasing environmental temperature in much the same manner as has been observed in larger animals which do not show chemical regulation in this range. This fall in average body temperature produces failure of regulation when the physiologic limit of storage is reached. Values are given for surface temperatures in conjunction with known levels From these values the of rectal temperature, air temperature, and metabolism. various conductances, including the environmental heat loss constants, have been computed. Derived values for average body temperature are presented as an illustration of the gradual failure of heat regulation in progressively colder environments. Theoretical considerations are presented in regard to the practical limit of chemical regulation which suggest that such a limit is not entirely dependent upon the reserve of heat-producing capacity. AUTHOR.
Seltzer, cise.
Carl Am.
C.: Body J. Physiol.
Build 129:
and Oxygen 1, 1940.
Metabolism
at Rest
and
During
Exer-
The rssults of this investigation with respect to the interrelation of body build and oxygen metabolism may be summarized as follows: There appears to be a relation of a constitutional nature between morphology of individuals and their consumption of oxygen. The more “linear” individuals and those with relatively shorter upper and 5atter chest outlines, and with narrower hips lower extremities, longer torsos, relative to breadth of shoulders have higher oxygen intakes in the resting ,&ate than their “lateral” counterparts. This appears to be the case irrespective of whether the oxygen consumption is related to body weight or surface area. With respect to moderate exercise smaller oxygen intakes per kilo of body weight are displayed by individuals who are more “lateral” than “linear. ”