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Am J Physiol Heart Circ Physiol 279: H1931-H1940, 2000;
0363-6135/00 $5.00
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Vol. 279, Issue 4, H1931-H1940, October 2000

Cardiovascular and neuroendocrine responses to water immersion in compensated heart failure

Anders Gabrielsen1, Vibeke B. Sørensen2, Bettina Pump1, Søren Galatius2, Regitze Videbæk2, Peter Bie3, Jørgen Warberg3, Niels Juel Christensen4, Henrik Wroblewski2, Jens Kastrup2, and Peter Norsk1

1 Danish Aerospace Medical Centre of Research and 2 The Heart Center, National University Hospital, Rigshospitalet, DK-2100 Copenhagen; 3 Department of Medical Physiology, Panum Institute, University of Copenhagen, DK-2200 Copenhagen; and 4 Department of Internal Medicine and Endocrinology, Herlev Hospital, University of Copenhagen, DK-2730 Herlev, Denmark

The hypothesis was tested that cardiovascular and neuroendocrine (norepinephrine, renin, and vasopressin) responses to central blood volume expansion are blunted in compensated heart failure (HF). Nine HF patients [New York Heart Association class II-III, ejection fraction = 0.28 ± 0.02 (SE)] and 10 age-matched controls (ejection fraction = 0.68 ± 0.03) underwent 30 min of thermoneutral (34.7 ± 0.02°C) water immersion (WI) to the xiphoid process. WI increased (P < 0.05) central venous pressure by 3.7 ± 0.6 and 3.2 ± 0.4 mmHg and stroke volume index by 12.2 ± 2.1 and 7.2 ± 2.1 ml · beat-1 · m-2 in controls and HF patients, respectively. During WI, systemic vascular resistance decreased (P < 0.05) similarly by 365 ± 66 and 582 ± 227 dyn · s · cm-5 in controls and HF patients, respectively. Forearm subcutaneous vascular resistance decreased by 19 ± 7% (P < 0.05) in controls but did not change in HF patients. Heart rate decreased less during WI in HF patients, whereas release of norepinephrine, renin, and vasopressin was suppressed similarly in the two groups. We suggest that reflex control of forearm vascular beds and heart rate is blunted in compensated HF but that baroreflex-mediated systemic vasodilatation and neuroendocrine responses to central blood volume expansion are preserved.

sympathetic nervous activity; arginine vasopressin; renin-angiotensin system; endothelin; baroreceptors


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