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Increased Red Cell Volume Is a Relevant Contributing Factor to an Expanded Blood Volume in Compensated Systolic Chronic Heart Failure.
J Card Fail. 2020 May; 26(5):420-428.JC

Abstract

BACKGROUND

In patients with chronic heart failure (CHF), volume overload is usually described as an expansion of plasma volume. Additional red cell volume (RCV) expansion is less commonly recognized. So far, little is known about quantitative differences in blood volume status and its different components in patients with stable CHF compared to healthy controls.

METHODS

This study aimed to quantify blood volume and its constituents, RCV and plasma volume, by using an abbreviated carbon monoxide rebreathing method with particular focus on its primary measure total hemoglobin mass in 47 patients (10 women) with systolic CHF and a left ventricular ejection fraction of 29.0 ± 9.4%. These were compared to an age-matched control group of 84 healthy subjects (44 women) using the same method.

RESULTS

In both absolute and body-surface-area-corrected analysis, hemoglobin mass (446 ± 81 vs 353 ± 64 g/m2) as well as RCV (1293 ± 231 vs 1033 ± 176 mL/m2) were significantly increased in CHF. In addition, significant plasma volume expansion was observed in CHF (2069 ± 400 vs 1750 ± 231 mL/m2) and, in conjunction with RCV, constituted a significantly increased blood volume (3361 ± 574 vs 2783 ± 369 mL/m2). In 66% of patients with compensated CHF, RCV was excessive compared to 14% in the control group.

CONCLUSIONS

An increased RCV is a relevant contributing factor to hypervolemia in stable CHF. This is associated with an increased oxygen-carrying capacity, so it may be regarded as a possible compensatory mechanism for a reduced ejection fraction.

Authors+Show Affiliations

Center for Medicine, Institute for Exercise- and Occupational Medicine, Medical Center, Faculty of Medicine, University of Freiburg, Germany.Department of Cardiology and Angiology I, Heart Center Freiburg University, Faculty of Medicine, University of Freiburg, Germany.Department of Cardiology and Angiology I, Heart Center Freiburg University, Faculty of Medicine, University of Freiburg, Germany.Center for Medicine, Institute for Exercise- and Occupational Medicine, Medical Center, Faculty of Medicine, University of Freiburg, Germany.Department of Cardiology and Angiology I, Heart Center Freiburg University, Faculty of Medicine, University of Freiburg, Germany.Department of Cardiology and Angiology I, Heart Center Freiburg University, Faculty of Medicine, University of Freiburg, Germany.Department of Cardiology and Angiology I, Heart Center Freiburg University, Faculty of Medicine, University of Freiburg, Germany. Electronic address: torben.pottgiesser@universitaets-herzzentrum.de.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31790816

Citation

Ahlgrim, Christoph, et al. "Increased Red Cell Volume Is a Relevant Contributing Factor to an Expanded Blood Volume in Compensated Systolic Chronic Heart Failure." Journal of Cardiac Failure, vol. 26, no. 5, 2020, pp. 420-428.
Ahlgrim C, Birkner P, Seiler F, et al. Increased Red Cell Volume Is a Relevant Contributing Factor to an Expanded Blood Volume in Compensated Systolic Chronic Heart Failure. J Card Fail. 2020;26(5):420-428.
Ahlgrim, C., Birkner, P., Seiler, F., Wrobel, N., Grundmann, S., Bode, C., & Pottgiesser, T. (2020). Increased Red Cell Volume Is a Relevant Contributing Factor to an Expanded Blood Volume in Compensated Systolic Chronic Heart Failure. Journal of Cardiac Failure, 26(5), 420-428. https://doi.org/10.1016/j.cardfail.2019.11.025
Ahlgrim C, et al. Increased Red Cell Volume Is a Relevant Contributing Factor to an Expanded Blood Volume in Compensated Systolic Chronic Heart Failure. J Card Fail. 2020;26(5):420-428. PubMed PMID: 31790816.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased Red Cell Volume Is a Relevant Contributing Factor to an Expanded Blood Volume in Compensated Systolic Chronic Heart Failure. AU - Ahlgrim,Christoph, AU - Birkner,Philipp, AU - Seiler,Florian, AU - Wrobel,Nina, AU - Grundmann,Sebastian, AU - Bode,Christoph, AU - Pottgiesser,Torben, Y1 - 2019/11/30/ PY - 2019/07/18/received PY - 2019/11/11/revised PY - 2019/11/26/accepted PY - 2019/12/4/pubmed PY - 2019/12/4/medline PY - 2019/12/3/entrez KW - Heart failure KW - blood volume KW - hemodilution KW - pathophysiology KW - plasma volume KW - red cell volume KW - total hemoglobin mass KW - volume overload SP - 420 EP - 428 JF - Journal of cardiac failure JO - J. Card. Fail. VL - 26 IS - 5 N2 - BACKGROUND: In patients with chronic heart failure (CHF), volume overload is usually described as an expansion of plasma volume. Additional red cell volume (RCV) expansion is less commonly recognized. So far, little is known about quantitative differences in blood volume status and its different components in patients with stable CHF compared to healthy controls. METHODS: This study aimed to quantify blood volume and its constituents, RCV and plasma volume, by using an abbreviated carbon monoxide rebreathing method with particular focus on its primary measure total hemoglobin mass in 47 patients (10 women) with systolic CHF and a left ventricular ejection fraction of 29.0 ± 9.4%. These were compared to an age-matched control group of 84 healthy subjects (44 women) using the same method. RESULTS: In both absolute and body-surface-area-corrected analysis, hemoglobin mass (446 ± 81 vs 353 ± 64 g/m2) as well as RCV (1293 ± 231 vs 1033 ± 176 mL/m2) were significantly increased in CHF. In addition, significant plasma volume expansion was observed in CHF (2069 ± 400 vs 1750 ± 231 mL/m2) and, in conjunction with RCV, constituted a significantly increased blood volume (3361 ± 574 vs 2783 ± 369 mL/m2). In 66% of patients with compensated CHF, RCV was excessive compared to 14% in the control group. CONCLUSIONS: An increased RCV is a relevant contributing factor to hypervolemia in stable CHF. This is associated with an increased oxygen-carrying capacity, so it may be regarded as a possible compensatory mechanism for a reduced ejection fraction. SN - 1532-8414 UR - https://www.unboundmedicine.com/medline/citation/31790816/Increased_Red_Cell_Volume_Is_a_Relevant_Contributing_Factor_to_an_Expanded_Blood_Volume_in_Compensated_Systolic_Chronic_Heart_Failure L2 - https://linkinghub.elsevier.com/retrieve/pii/S1071-9164(19)30784-5 DB - PRIME DP - Unbound Medicine ER -
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