Blood Volume Measurements in Patients With Heart Failure and a Preserved Ejection Fraction: Implications for Diagnosing Anemia

Noumi, Bassel; Teruya, Sergio; Salomon, Say; Helmke, Stephen; Maurer, Mathew S.

doi:10.1111/j.1751-7133.2010.00208.x

Cited by 21 publications

(25 citation statements)

References 28 publications

(57 reference statements)

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“…Patients with‘ pre-clinical’ HFpEF often have impaired natriuretic function [165], and even seemingly well compensated HFpEF patients often have elevated plasma volume [166]. Some view volume overload and congestion as key contributors to HF development and progression [167].…”

Section: Rv Dysfunction Pulmonary Vascular Disease and Other Hemodynmentioning

confidence: 99%

Heart failure with preserved ejection fraction in the elderly: scope of the problem

Upadhya

Taffet

Cheng

et al. 2015

Journal of Molecular and Cellular Cardiology

115

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Heart failure with preserved ejection fraction (HFpEF) is the most common form of heart failure (HF) in older adults, particularly women, and is increasing in prevalence as the population ages. With morbidity and mortality on par with HF with reduced ejection fraction, it remains a most challenging clinical syndrome for the practicing clinician and basic research scientist. Originally considered to be predominantly caused by diastolic dysfunction, more recent insights indicate that HFpEF in older persons is typified by a broad range of cardiac and non-cardiac abnormalities and reduced reserve capacity in multiple organ systems. The globally reduced reserve capacity is driven by: 1) inherent age-related changes; 2) multiple, concomitant co-morbidities; 3) HFpEF itself, which is likely a systemic disorder. These insights help explain why: 1) comorbidities are among the strongest predictors of outcomes; 2) approximately 50% of clinical events in HFpEF patients are non-cardiovascular; 3) clinical drug trials in HFpEF have been negative on their primary outcomes. Embracing HFpEF as a true geriatric syndrome, with complex, multi-factorial pathophysiology and clinical heterogeneity could provide new mechanistic insights and opportunities for progress in management.

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Section: Rv Dysfunction Pulmonary Vascular Disease and Other Hemodynmentioning

confidence: 99%

Heart failure with preserved ejection fraction in the elderly: scope of the problem

Upadhya

Taffet

Cheng

et al. 2015

Journal of Molecular and Cellular Cardiology

115

View full text Add to dashboard Cite

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“…Extracellular water assessed using whole‐body bioelectrical impedance is also increased in patients with anemia 2 . As previously pointed out, this association appears throughout the spectrum of CHF, being also present in patients with preserved LV systolic function 1,2 . However, hemodilution may also be present in patients who appear to have euvolemia 12,25 …”

mentioning

confidence: 77%

“…Recent studies have demonstrated the relevance of extracellular volume measurement for the diagnosis of anemia in chronic heart failure both with systolic dysfunction and preserved left ventricular function 1,2 . However, the implications for treatment have not been comprehensively elucidated.…”

mentioning

confidence: 99%

Perspectives for the Treatment of Anemia in Heart Failure: Is There a Role for Vasopressin Antagonists?

Marques

2011

Congestive Heart Failure

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Anemia is an independent predictor of mortality in congestive heart failure patients. Recent studies have recognized that dilutional anemia is highly prevalent in this population. However, the implications for treatment have not been comprehensively elucidated. In this regard, arginine-vasopressin antagonists, by increasing aquaresis, may be an attractive treatment option. Nevertheless, only indirect evidence supports the hypothesis that arginine-vasopressin antagonists may be useful in the treatment of congestive heart failure anemia. Therefore, future clinical research should explore the role of arginine-vasopressin pathway activation in determining dilutional anemia and, ultimately, assess it as a therapeutic target.

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“…Specimens will be analyzed with an automated system (BVA100 Blood Volume Analyzer, Daxor Corp., NY). 35 …”

Section: Methodsmentioning

confidence: 99%

Evaluating the safety and efficacy of sodium-restricted/Dietary Approaches to Stop Hypertension diet after acute decompensated heart failure hospitalization: Design and rationale for the Geriatric OUt of hospital Randomized MEal Trial in Heart Failure (GOURMET-HF)

Wessler

Maurer

Hummel

2015

American Heart Journal

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Background Heart Failure (HF) is a major public health problem affecting predominantly older adults. Non-adherence to diet remains a significant contributor to acute decompensated HF (ADHF). The sodium-restricted Dietary Approaches to Stop Hypertension (DASH/SRD) eating plan reduces cardiovascular dysfunction that can lead to ADHF and is consistent with current HF guidelines. We propose that an intervention that promotes adherence to the DASH/SRD by home-delivering meals will be safe and improve health-related quality of life (QOL) in older adults following hospitalization for ADHF. Methods/Design This is a three center, randomized, single-blind, controlled trial of 12 weeks duration designed to determine the safety and efficacy of home-delivered DASH/SRD-compliant meals in older adults following discharge from ADHF hospitalization. 66 subjects will be randomized in a 1:1 stratified fashion by gender and left ventricular ejection fraction (< vs. ≥50%). Study subjects will receive either pre-prepared, home-delivered DASH/SRD-compliant meals or usual dietary advice for 4 weeks after hospital discharge. Investigators will be blinded to group assignment, food diaries, and urinary electrolyte measurements until study completion. The primary efficacy endpoint is the change in the Kansas City Cardiomyopathy Questionnaire (KCCQ) summary scores for health-related QOL from study enrollment to 4 weeks post-discharge. Safety evaluation will focus on hypotension, renal insufficiency, and hyperkalemia. Exploratory endpoints include echocardiography, non-invasive vascular testing, markers of oxidative stress, and salt taste sensitivity. Conclusion This randomized controlled trial will test the efficacy, feasibility and safety of 4 weeks of DASH/SRD after ADHF hospitalization. By testing a novel dietary intervention supported by multiple levels of evidence including preliminary data in outpatients with stable HF, we will address a critical evidence gap in the care of older patients with ADHF. If effective and safe, this intervention could be scaled to assess effects on readmission and healthcare costs in older adults following ADHF.

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Blood Volume Measurements in Patients With Heart Failure and a Preserved Ejection Fraction: Implications for Diagnosing Anemia

Cited by 21 publications

References 28 publications

Heart failure with preserved ejection fraction in the elderly: scope of the problem

Heart failure with preserved ejection fraction in the elderly: scope of the problem

Perspectives for the Treatment of Anemia in Heart Failure: Is There a Role for Vasopressin Antagonists?

Evaluating the safety and efficacy of sodium-restricted/Dietary Approaches to Stop Hypertension diet after acute decompensated heart failure hospitalization: Design and rationale for the Geriatric OUt of hospital Randomized MEal Trial in Heart Failure (GOURMET-HF)

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