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Reduced Arterial Dilator Capacity : A Characteristic Abnormality of the Peripheral Vascular Bed in Human Congestive Heart Failure.

Robert Zelis, M.D.; Dean T. Mason, M.D. (Associate); and Eugene Braunwald, M.D., F.A.C.P.
Ann Intern Med. 1967;66(5):1039. doi:10.7326/0003-4819-66-5-1039_3
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Although vasoconstriction characteristic of congestive heart failure is attributed to augmented sympathetic nervous activity, the possibility of an abnormality inherent in the vessel wall was considered. The responses of the resistance bed in the forearm to the restoration of circulation after inflow occlusion (reactive hyperemia), to hand exercise (active hyperemia), and to local heating were compared in 13 patients with congestive heart failure and 12 normal subjects. Forearm blood flow was measured plethysmographically. In the normal subjects, total reactive hyperemia blood flow after 3, 5, and 10 min of arterial occlusion averaged 6.1, 12.6, and 29.5 ml and was significantly


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