Vasopressin in congestive heart failure.
The mechanisms involved in the abnormal water excretion in patients with congestive heart failure (CHF) are poorly understood. Intrarenal mechanisms (decreased glomerular filtration rate, increased proximal tubular reabsorption) and extrarenal mechanisms (nonosmotic stimulation of arginine vasopressin (AVP)) have been suggested, but their relative importance is unknown. Also, the relationships with altered intracardiac hemodynamics have not been previously assessed. Based on plasma and "platelet" AVP determinations, intracardiac measurements, and other hormonal determinations performed in a series of patients with severe CHF, we conclude that plasma AVP and platelet AVP are the major determinants of the abnormal water excretion in patients with severe CHF. In these patients, enhanced AVP release may be the result of baroreceptor stimulation from a decreased effective arterial blood volume, possibly sensed at specific intraventricular cardiac sites.
D001127:Arginine Vasopressin / Q000097:blood / Q000494:pharmacology; D001792:Blood Platelets / Q000378:metabolism; D001810:Blood Volume / Q000187:drug effects; D006333:Heart Failure / Q000503:physiopathology*; D006801:Humans; D012083:Renin / Q000097:blood; D014667:Vasopressins / Q000502:physiology*
D014667:Vasopressins; D001127:Arginine Vasopressin; D012083:Renin