[Disorders of nitrogen metabolism in circulatory insufficiency]

The state of nitrogen metabolism was studied on the basis of clinical observations and nitrogen metabolism indices in 102 patients with circulatory insufficiency occurring against the background of rheumatic heart diseases, atherosclerotic cardiosclerosis and chronic corpulmonale. Nitrogen metabolism disorders were found in all stages of circulatory insufficiency. These disorders may be the cause of these patients' resistance to therapy.

[Changes in the protein and energy metabolism and their correction in patients with circulatory insufficiency]

Chronic hypoxia arising in cases of circulatory insufficiency brings on changes in all kinds of metabolism, including that of energy and protein. Patients suffering from circulatory insufficiency should be treated with due regard for metabolic shifts occurring in cases of cardiac incompetence. A total of 180 patients with circulatory insufficiency of the I-IIIstage were examined by employing up-to-date methods in studying the state of the energy, carbohydrate, protein, amino acids metabolism and the hepatic function. The patients underwent medication with drugs influencing the metabolic processes and with combinations of such drugs and the clinical effect of such a type of the treatment is assessed.

[Pathogenesis of cachexia in cardiac insufficiency]

In 81 patients with circulatory insufficiency of the IIB-III stage some in dices of the lipids and protein metabolism along with the blood sugar level were studied. Changes in the lipids metabolism values are more pronounced in patients with mitral defects than in those with atherosclerotic cardiosclerosis. The authors attach definite importance to these derangements in the pathogenesis of cardiac cachexia secondary to the developing circulatory insufficiency.

[Content and distribution of water and potassium in the body of patients with chronic circulatory insufficiency]

The total water content (after antipyrine and tritium oxide), that of extracellular water (after sodium thiosulphate) and of overall metabolic potassium (with reference to K42) were studied concurrently in 34 patients with chronic circulatory insufficiency. Twenty normal subjects served as controls. In the sick the disturbances of the water metabolism made themselves felt not only in the accumulation of surplus water in the body, but also in its re-distribution. In the presence of marked edemas the total water level rises both at the expense of extra- and intracellular water. With the normal level of total water the extracellular water fraction is up and the intracellular one is down. An early and consistent sign of circulatory insufficiency is a drop in the amount of overall metabolic potassium in the body. The potassium deficit increases parallel with progressing circulatory insufficiency, being contingent not only upon the reduction of the cellular mass, but also on the lower intracellular concentration of potassium. The concentration of potassium in the plasma does not reflect the overall content of it in the body.