Cardiac contractility, central haemodynamics and blood pressure regulation during semistarvation

TY - JOUR

T1 - Cardiac contractility, central haemodynamics and blood pressure regulation during semistarvation

AU - Stokholm, K H

AU - Breum, Leif

AU - Astrup, Arne

PY - 1991

Y1 - 1991

N2 - Eight obese patients were studied before and after 2 weeks of treatment by a very‐low‐calorie diet (VLCD). Cardiac output and central blood volume (pulmonary blood volume and left atrial volume) were determined by indicator dilution (125I‐albumin) and radionuclide angiocardiography (first pass and equilibrium technique by [99Tcm]red blood cells). Cardiac output decreased concomitantly with the reduction in oxygen uptake as the calculated systemic arteriovenous difference of oxygen was unaltered. There were no significant decreases in left ventricular contractility indices, i.e. the ejection fraction, the peak ejection rate and changes in end‐systolic volume. Also the diastolic function evaluated by the peak filling rate remained normal. Furthermore, no sign of backward failure could be demonstrated since the central blood volume was not significantly increased. Both systolic and diastolic blood pressure (BP) declined. The fall in BP was caused by the reduction in cardiac output as the total peripheral resistance was unchanged. Finally, the decline in total blood volume was not significant. These findings together with a reduction in heart rate indicated that a reduced sympathetic tone via increased capacitance of the venous bed was the main operator of a reduced venous return. Thus, the haemodynamic alterations in obese patients during short‐term semistarvation may be caused by the fall in oxygen uptake and produced mainly by changes in the sympathetic tone.

AB - Eight obese patients were studied before and after 2 weeks of treatment by a very‐low‐calorie diet (VLCD). Cardiac output and central blood volume (pulmonary blood volume and left atrial volume) were determined by indicator dilution (125I‐albumin) and radionuclide angiocardiography (first pass and equilibrium technique by [99Tcm]red blood cells). Cardiac output decreased concomitantly with the reduction in oxygen uptake as the calculated systemic arteriovenous difference of oxygen was unaltered. There were no significant decreases in left ventricular contractility indices, i.e. the ejection fraction, the peak ejection rate and changes in end‐systolic volume. Also the diastolic function evaluated by the peak filling rate remained normal. Furthermore, no sign of backward failure could be demonstrated since the central blood volume was not significantly increased. Both systolic and diastolic blood pressure (BP) declined. The fall in BP was caused by the reduction in cardiac output as the total peripheral resistance was unchanged. Finally, the decline in total blood volume was not significant. These findings together with a reduction in heart rate indicated that a reduced sympathetic tone via increased capacitance of the venous bed was the main operator of a reduced venous return. Thus, the haemodynamic alterations in obese patients during short‐term semistarvation may be caused by the fall in oxygen uptake and produced mainly by changes in the sympathetic tone.

KW - Blood pressure

KW - Cardiac output

KW - Energy metabolism

KW - Myocardial contraction

KW - Obesity

KW - Very‐low‐calorie diet

U2 - 10.1111/j.1475-097X.1991.tb00671.x

DO - 10.1111/j.1475-097X.1991.tb00671.x

M3 - Journal article

C2 - 1769186

AN - SCOPUS:0025953522

SN - 0144-5979

VL - 11

SP - 513

EP - 523

JO - Clinical Physiology

JF - Clinical Physiology

IS - 6

ER -