Adrenocortical insufficiency

Hofmann, Frederick G.; Sobel, Edna H.

doi:10.1007/978-3-662-13132-9_2

Cited by 2 publications

(1 citation statement)

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“…Circulatory collapse is a prominent feature of chronic adrenal insufficiency, i. e., four to ten days after adrenalectomy with no steroid support (1,3,4,9). The data presented in this study show direct evidence for an impairment of myocardial performance in chronically adrenalectomized cats.…”

Section: Discussionmentioning

confidence: 50%

Cardiac Performance in Experimental Adrenal Insufficiency in Cats

Lefer

Verrier

Carson

1968

Circulation Research

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Cardiac function was evaluated by ventricular function curves during the cardiovascular collapse observed in acute and chronic adrenal insufficiency. A progressive decline in peak cardiac work was observed in the acutely adrenalectomized cat (303; decrease at 1.8 hours and 50% at 3.5 hours after adrenalectomy). This impairment in cardiac work paralleled the decrease in mean arterial blood pressure which reached 50 mm Hg 3.5 hours after adrenalectomy. Cortisol and d-aldosterone, and the volume-expander, dextran, prevented a significant fall in mean arterial blood pressure and in peak cardiac work. When the mean arterial blood pressure of nonadrenalectomized cats was adjusted to follow the changes seen in adrenalectomized cats, a 49% depression in cardiac work resulted 3.5 hours after the initial decline in arterial blood pressure. The data suggest that the time course of the hypotension and presumed reduction in coronary perfusion pressure is sufficient to account for the large impairment in peak cardiac work observed. Cardiac work was reduced 56% in chronically adrenalectomized cats 8 to 10 days after adrenalectomy. Dexamethasone and deoxycorticosterone acetate, administered separately, prevented significant-myocardial impairment. Since the mean arterial blood pressure of conscious, chronically adrenalectomized cats was normal, the myocardial depression was not secondary to inadequate coronary perfusion in chronic adrenal insufficiency and thus represents direct impairment of myocardial performance. ent circulatory disturbance than does chronic adrenal insufficiency (5), both must be investigated. The purposes of the present study were to evaluate cardiac performance in acute and chronic adrenal insufficiency using a direct technique, to determine the relative efficacy of glucocorticoids and mineralocorticoids in protecting against post-adrenalectomy circulatory collapse, and to determine whether any observed changes in ventricular performance are independent of changes in systemic arterial pressure. MethodsOne hundred and twenty-four mongrel cats of both sexes and of mean weight 2.71 kg (1.9 to 3.8 kg) were studied. The control cats were anesthetized with 30 mg/kg of sodium pentobarbital, but the adrenalectomized cats without steroid support required only 15 mg/kg.

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Section: Discussionmentioning

confidence: 50%