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Contracted plasma and blood volume in chronic heart failure.
J Am Coll Cardiol. 2000 Jan; 35(1):51-5.JACC

Abstract

OBJECTIVES

The purpose of this study was to determine if long-term pharmacotherapy mediated changes in intravascular plasma and blood volumes in patients with chronic heart failure (CHF).

BACKGROUND

Intravascular fluid volume expansion is an acute compensatory adaptation to ventricular dysfunction in patients with CHF. To our knowledge there are no reports on plasma and blood volume measures in clinically stable patients with CHF receiving standard pharmacotherapy. Such information may provide a better understanding of the clinical hallmarks of heart failure.

METHODS

Plasma volume (PV) and blood volume (BV) were measured in 12 patients (62.8 +/- 8.2 years old, 175.2 +/- 6.8 cm, 96.2 +/- 18.2 kg, peak oxygen consumption (VO2max) 15.2 +/- 3.3 ml/kg per min) with CHF secondary to coronary artery disease (left ventricular ejection fraction 31.2 +/- 9.7, New York Heart Association functional class 2.5 +/- 0.5) and seven healthy subjects (71.7 +/- 5.3 years old, 177.1 +/- 10.8 cm, 84.4 +/- 11.7 kg, VO2max 26.0 +/- 6.5 ml/kg per min) 3 to 4 h after eating and after supine rest using the Evan's blue dye dilution technique. Venous blood samples were collected before blue dye infusion and analyzed for hematocrit (corrected 4% for trapped plasma and venous to whole body hematocrit ratio) and hemoglobin.

RESULTS

Hematocrit was 36.6 +/- 3.5% and 37.4 +/- 1.1%, and hemoglobin was 15.4 +/- 1.9 and 16.2 +/- 1.4 g/dl for patients with CHF and control subjects, respectively. Absolute PV was 3489.3 +/- 655.0 and 3728.7 +/- 813.2 ml, and absolute BV was 5,496.8 +/- 1,025.4 and 5,942.4 +/- 1,182.2 ml in patients with CHF and control subjects, respectively. Relative PV was 34.1 +/- 12.9 versus 44.5 +/- 9.0 ml/kg (p < or = 0.05), and relative BV was 58.5 +/- 12.3 versus 70.8 +/- 12.6 ml/kg (p < or = 0.05) in patients with CHF and control subjects, respectively.

CONCLUSIONS

Our data indicate significantly lower intravascular volumes in patients with CHF than in control subjects, indicating a deconditioned state or excessive diuresis, or both. The contracted PV and BV may contribute to exercise intolerance, shortness of breath and chronic fatigue, secondary to reduced cardiac output or regional blood flow, or both.

Authors+Show Affiliations

Department of Health and Exercise Science, Furman University, Greenville, South Carolina 29613, USA. Matt.Feigenbaum@Furman.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10636258

Citation

Feigenbaum, M S., et al. "Contracted Plasma and Blood Volume in Chronic Heart Failure." Journal of the American College of Cardiology, vol. 35, no. 1, 2000, pp. 51-5.
Feigenbaum MS, Welsch MA, Mitchell M, et al. Contracted plasma and blood volume in chronic heart failure. J Am Coll Cardiol. 2000;35(1):51-5.
Feigenbaum, M. S., Welsch, M. A., Mitchell, M., Vincent, K., Braith, R. W., & Pepine, C. J. (2000). Contracted plasma and blood volume in chronic heart failure. Journal of the American College of Cardiology, 35(1), 51-5.
Feigenbaum MS, et al. Contracted Plasma and Blood Volume in Chronic Heart Failure. J Am Coll Cardiol. 2000;35(1):51-5. PubMed PMID: 10636258.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Contracted plasma and blood volume in chronic heart failure. AU - Feigenbaum,M S, AU - Welsch,M A, AU - Mitchell,M, AU - Vincent,K, AU - Braith,R W, AU - Pepine,C J, PY - 2000/1/15/pubmed PY - 2000/1/15/medline PY - 2000/1/15/entrez SP - 51 EP - 5 JF - Journal of the American College of Cardiology JO - J. Am. Coll. Cardiol. VL - 35 IS - 1 N2 - OBJECTIVES: The purpose of this study was to determine if long-term pharmacotherapy mediated changes in intravascular plasma and blood volumes in patients with chronic heart failure (CHF). BACKGROUND: Intravascular fluid volume expansion is an acute compensatory adaptation to ventricular dysfunction in patients with CHF. To our knowledge there are no reports on plasma and blood volume measures in clinically stable patients with CHF receiving standard pharmacotherapy. Such information may provide a better understanding of the clinical hallmarks of heart failure. METHODS: Plasma volume (PV) and blood volume (BV) were measured in 12 patients (62.8 +/- 8.2 years old, 175.2 +/- 6.8 cm, 96.2 +/- 18.2 kg, peak oxygen consumption (VO2max) 15.2 +/- 3.3 ml/kg per min) with CHF secondary to coronary artery disease (left ventricular ejection fraction 31.2 +/- 9.7, New York Heart Association functional class 2.5 +/- 0.5) and seven healthy subjects (71.7 +/- 5.3 years old, 177.1 +/- 10.8 cm, 84.4 +/- 11.7 kg, VO2max 26.0 +/- 6.5 ml/kg per min) 3 to 4 h after eating and after supine rest using the Evan's blue dye dilution technique. Venous blood samples were collected before blue dye infusion and analyzed for hematocrit (corrected 4% for trapped plasma and venous to whole body hematocrit ratio) and hemoglobin. RESULTS: Hematocrit was 36.6 +/- 3.5% and 37.4 +/- 1.1%, and hemoglobin was 15.4 +/- 1.9 and 16.2 +/- 1.4 g/dl for patients with CHF and control subjects, respectively. Absolute PV was 3489.3 +/- 655.0 and 3728.7 +/- 813.2 ml, and absolute BV was 5,496.8 +/- 1,025.4 and 5,942.4 +/- 1,182.2 ml in patients with CHF and control subjects, respectively. Relative PV was 34.1 +/- 12.9 versus 44.5 +/- 9.0 ml/kg (p < or = 0.05), and relative BV was 58.5 +/- 12.3 versus 70.8 +/- 12.6 ml/kg (p < or = 0.05) in patients with CHF and control subjects, respectively. CONCLUSIONS: Our data indicate significantly lower intravascular volumes in patients with CHF than in control subjects, indicating a deconditioned state or excessive diuresis, or both. The contracted PV and BV may contribute to exercise intolerance, shortness of breath and chronic fatigue, secondary to reduced cardiac output or regional blood flow, or both. SN - 0735-1097 UR - https://www.unboundmedicine.com/medline/citation/10636258/Contracted_plasma_and_blood_volume_in_chronic_heart_failure_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-1097(99)00530-6 DB - PRIME DP - Unbound Medicine ER -