The metabolism of water and electrolytes in congestive heart failure. II. The distribution of water and electrolytes in skeletal muscle in edematous patients with congestive heart failure before and after treatment.

Abstract

Abstract Specimens of skeletal muscle obtained from eight patients with cardiac edema and eight patients who had been edematous but who were partially or completely free of edema at the time of the biopsy were studied. The edema of heart failure is characterized by an increase in total tissue water representing an increase in both extra- and intracellular water content. The sodium and chloride content of edematous tissues are increased over control values. This increase is characterized by a proportionately greater increase in tissue chloride than sodium resulting in a decreased Na:Cl ratio in the presence of edema. The decreased intracellular cation concentration observed in edematous muscle is related principally to a decreased intracellular potassium concentration resulting from an increase in intracellular water content and arising from a hypotonic dilution of tissue solids. Treatment of the edema of heart failure leads to a decrease in the water content of intra- and extracellular phases with a concomitant return of intracellular cation concentration to normal levels.