The Retardation of Erythrocyte Sedimentation in Congestive Heart Failure

While it is generally believed that congestive heart failure retards erythrocyte sedimentation (E.S.R.) the data of McGinnis et al. (1953) indicated that the E.S.R. tends to be elevated in both acute and chronic congestive failure. From a study of E.S.R. in 190 patients with cardiac failure ofvaried aetiology, Sanghvi (1960) concluded that heart failure has a retarding influence on the E.S.R. and tends to bring nearer to the normal the E.S.R. in diseases known to be associated with abnor- mally elevated values; he also found that elevation of the E.S.R. values after compensation is due to removal of this retarding influence. The cause of retardation of the E.S.R. during failure or of elevation after compensation is not yet known, and publications on the subject are few. McGinnis et al. (1953) suggested that absorption of products of tissue necrosis as a result of passive congestion may play a part in the increase of E.S.R. in the period immediately after compensation. Parry (1961) in a study of factors which may influence the E.S.R. in heart failure found no correlation between the changes in the E.S.R. and in the plasma fibrinogen and serum protein fractions. The purpose of this paper is to report a study, during heart failure and after establishment of compensation, of E.S.R. and various factors known to influence the E.S.R. in 35 patients.