Distribution, conjugation, and excretion of labeled aldosterone in congestive heart failure and in controls with normal circulation: development and testing of a model with an analog computer.

The distribution and clearance of aldosterone from plasma determine the fraction of secreted hormone reaching sites where the cellular actions of the hormone occur. Tait, Tait, Little, and Laumas (1) described the disappearance of aldosterone from plasma of normal man in terms of a two compartment system. Davis, Olichney, Brown, and Binnion (2) showed that the volumes of distribution and rates of clearance of aldosterone are reduced in dogs with experimental heart failure and low cardiac output. Our findings indicate that marked alterations in distribution and clearance of aldosterone are present in patients with congestive failure. Tait, Little, Tait, and Flood (3) estimated the mean plasma concentration of aldosterone in human plasma from the secretion rate and the plasma clearance rate. Ayers and his colleagues (4) and Tait and associates (5) showed that hepatic clearance of aldosterone is subnormal in dogs or in man in congestive failure (4). Camargo, Dowdy, Hancock, and Luetscher (6) demonstrated that reduced hepatic clearance and extraction of aldosterone may contribute to an increased concentration in plasma of patients with heart failure. The liver extracts aldosterone from plasma and returns conjugates and metabolites to plasma, in