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Abstracts |

Abnormalities of the Peripheral Circulation in Congestive Heart Failure.

Robert Zelis, M.D.; James F. Spann Jr., M.D.; and Dean T. Mason, M.D., F.A.C.P.
Ann Intern Med. 1969;70(5):1082. doi:10.7326/0003-4819-70-5-1082_2
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Since cardiac output is reduced at rest and fails to rise normally during stress in patients with congestive heart failure, certain adjustments are necessary in the peripheral circulation to maintain circulatory function and redistribute blood flow. Studies in our laboratories have shown that profound sympathetic-mediated systemic, arteriolar, and venous constriction attends congestive heart failure and that the quantity of endogenous norepinephrine available for release by tyramine from sympathetic nerve endings in calf arterioles is elevated. Utilizing plethysmographic techniques and epinephrine iontophoresis, we have shown that early during the course of supine leg exercise patients with congestive heart failure demonstrate an


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