THE ROLE OF THE NERVOUS SYSTEM IN THE MAINTENANCE OF PULMONARY ARTERIAL HYPERTENSION IN HEART FAILURE

Abstract

Elevation of pressure in the pulmonary veins, with a consequent elevation of pressure in the pulmonary capillaries and pulmonary artery has for many years been invoked to explain pulmonary hypertension in both mitral stenosis and left ventricular failure. Ignoring the possibility of pul- monary vasoconstriction, this hypothesis was in complete accordance with the " mechanistic " concept of the regulation of pulmonary pressure, emphasized recently by Cournand (1947, 1950) and It was based mainly on the relative refractoriness of the pulmonary circula- tion towards substances affecting the systemic circulation.