The effects of posture on stroke volume, right ventricular end-diastolic and end-systolic volumes, cardiac output, and heart rate were studied in subjects without heart disease and patients with congestive heart failure. Cardiac catheterization was performed, and right ventricular volumes were measured by combining a direct Fick cardiac output determination with a thermodilution technique, while the subjects were supine and after they had been tilted to a 60-degree upright position. In the normal subjects, upright tilting resulted in a profound fall in stroke volume, an increase in heart rate, and a significant decrease in the size of the right ventricle, although the residual fraction increased. In contrast, in subjects with congestive heart failure, tilting to the upright position caused no significant changes.
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