Left ventricular dysfunction and extravascular fluid in the lung: physiological basis for symptoms.

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dc.contributor.authorRavi, Krishnanen_US
dc.contributor.authorKappagoda, C Tissaen_US
dc.date.accessioned2008-01-10en_US
dc.date.accessioned2009-05-27T10:12:16Z
dc.date.available2008-01-10en_US
dc.date.available2009-05-27T10:12:16Z
dc.date.issued2008-01-10en_US
dc.description91 references.en_US
dc.description.abstractThe essential feature of left ventricular dysfunction is an increase in left atrial pressure and pulmonary venous congestion leading to a fluid flux across the pulmonary microvasculature. Small acute increases (< 10 mmHg) in left atrial pressure enhance the extravascular fluid volume in the airways and activate the rapidly adapting receptors (RAR). With larger increases in left atrial pressure (approximately 25 mmHg) both the RAR and the C-fiber receptors in the airways and the alveoli are activated. Activation of RAR causes a reflex increase in respiratory rate, tracheal tone and mucus secretion from the airways. It appears that small increases in extravascular fluid volume of the airways also cause a reflex diuresis which is mediated by activation of neuronal nitric oxide synthase in the renal medulla. In contrast, when left atrial pressure is elevated chronically, further small increments in extravascular fluid volume of the airways no longer stimulate the RAR. The reflex diuresis is also not evident under these circumstances. However, the RAR continue to be activated by increments in left atrial pressure in excess of 25 mmHg. It is suggested that the RAR of the airways play a significant role in monitoring changes in the extravascular fluid volume of the airways and mediate the reflexes which are associated with the symptomatology of acute left ventricular dysfunction.en_US
dc.description.affiliationDepartment of Physiology, V.P. Chest Institute, University of Delhi, Delhi, India. revaravi@hotmail.comen_US
dc.identifier.citationRavi K, Kappagoda CT. Left ventricular dysfunction and extravascular fluid in the lung: physiological basis for symptoms. The Indian Journal of Chest Diseases & Allied Sciences. 2008 Jan-Mar; 50(1): 7-18en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/29359
dc.language.isoengen_US
dc.source.urihttps://medind.nic.in/iae/iaem.shtmlen_US
dc.subject.meshBaroreflex --physiologyen_US
dc.subject.meshExtravascular Lung Water --physiologyen_US
dc.subject.meshHumansen_US
dc.subject.meshMicrocirculation --physiologyen_US
dc.subject.meshPulmonary Circulation --physiologyen_US
dc.subject.meshSensory Receptor Cells --physiologyen_US
dc.subject.meshVentricular Dysfunction, Left --complicationsen_US
dc.titleLeft ventricular dysfunction and extravascular fluid in the lung: physiological basis for symptoms.en_US
dc.typeJournal Articleen_US
dc.typeReviewen_US
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