Contracted plasma and blood volume in chronic heart failure

Abstract

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.

2009 Focused Update Incorporated Into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults

“…Excessive use of diuretics can decrease blood pressure and impair renal function and exercise tolerance, [272][273][274]289 but hypotension and azotemia may also occur as a result of worsening HF, which may be exacerbated by attempts to reduce the dose of diuretics. If there are no signs of fluid retention, hypotension and azotemia are likely to be related to volume depletion and may resolve after a reduction in diuretic dose.…”

ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult

“…Excessive use of diuretics can decrease blood pressure and impair renal function and exercise tolerance (158)(159)(160)175), but hypotension and azotemia may also occur as a result of worsening HF, which may be exacerbated by attempts to reduce the dose of diuretics. If there are no signs of fluid retention, hypotension and azotemia are likely to be related to volume depletion and may resolve after a reduction in diuretic dose.…”

Effects of limiting fluid intake on clinical and laboratory outcomes in patients with heart failure

“…In addition, the limitation of water supply in the diet can aggravate the status of reduced effective circulating volume, which is in itself already present in heart failure, due to the fall in cardiac output and slowdown in the circulating flow. This reduction in intravascular volume is especially present in the cases of heart failure with marked systemic venous hypertension, widespread edema, or ascites [16,17]. In this scenar- …”