Cardiac output in Paget's disease: response to long-term salmon calcitonin therapy.

Abstract

Cardiac output in Paget's disease: response to long-term salmon calcitonin therapy Paget's disease is accompanied by an increase in the vascularity and flow of blood through bone.With sufficiently severe disease the peripheral vascular resistance decreases and the cardiac output (CO) increases above normal levels, either at rest or after exercise.'In some patients high-output congestive cardiac failure may be seen.As in patients with arteriovenous fistulae, the oxygen saturation of venous blood is increased and early venous filling occurs during arteriography.Anatomical arteriovenous shunts, however, have not been demonstrated in Paget's disease, and the increased venous oxygen saturation probably results from a rapid flow of blood through an enormously dilated capillary bed.2Long-term treatment of Paget's disease with calcitonin reduces the abnormally raised turnover of bone and sometimes produces radiological healing of the disease.3We therefore investigated the possibility that calcitonin treatment will, in addition, reduce the bone vascularity and thus lower the CO.