274 



Z. Fejfar 



to digitalis, and in the fifth group are patients refractory to 

 the usual methods of treatment. 



It may be seen that patients without right-sided failure 

 have a decreased renal blood flow in comparison with the 

 values in normal control subjects. 



On the other hand increase of pressure in the renal vein 

 brought about by a partial occlusion (Selkurt, Hall and 



) 2 3 A 5 



1 2 3 AXS 



12 3 4 5 



L2 34 5 



n A» 



Fig. 2. Renal blood flow in normal subjects and in patients with rheumatic 



(Rm and Rao)j hypertensive (H), ischaemic (I) and pulmonary (P) heart 



disease. All patients are divided into five groups according to the clinical 



degree of heart failure. See text for details. 



Spencer, 1949), or by an increased abdominal pressure (Brad- 

 ley and Bradley, 1947), is followed by only a small diminution 

 of the renal blood flow. 



Maxwell, Breed and Schwartz (1950) measured pressure in 

 the inferior vena cava in 17 healthy subjects and ten patients 

 with congestive failure. The mean pressure in healthy subjects 

 was 15-2 cm. HgO, and in patients with congestive failure 

 27 cm. HgO. From the measured values of pressure they 

 calculated that the increase of renal resistance due to the 

 elevation of pressure in renal veins would reduce renal blood 

 flow by about 14 per cent. The actual decrease in renal blood 

 flow in congestive failure is far greater (see Fig. 2). 



