Pulmonary Blood Volume in Congestive Heart Failure

IN ANALYZING the clinical and hemodynamic features of congestive heart failure due to myocardial disease or associated with mitral stenosis, many authors indicate or clearly imply that a significant augmentation in pulmonary blood volume plays a major role in the pathogenesis of pulmonary congestion and edema.'-6 These conclusions have depended largely upon indirect evidence such as clinical evaluation, the interpretation of chest roentgenograms, and the measurement of pulmonary vascular pressures and central blood volume. Utilization of indicator-dilution techniques, combined with simultaneous right and transseptal left heart catheterization, has made more precise quantitation of the true pulmonary blood volume (PBV) possible. The technique of Milnor and associates7 has been employed in our laboratory in the study of several hundred patients with valvular and other forms of acquired heart disease. It is the purpose of this presentation to (1) report the changes in PBV in a group of patients with heart failure associated with severe mitral stenosis and in another group of patients with nonvalvular congestive heart failure; (2) compare values of PBV in these patients with those obtained in a separate group of patients who had normal hemody-