Plasma volume status predicts prognosis in patients with acute heart failure syndromes

Abstract

Increased congestion is associated with increased morbidity and mortality in heart failure patients. Plasma volume status, which represents intravascular compartment and congestion, can identify poor prognosis in patients with acute heart failure syndromes.

Calculated plasma volume status and outcomes in patients undergoing coronary bypass graft surgery

“…Similarly, in 1115 patients hospitalised for acute heart failure, each 1% increment in admission PVS was associated with a 21% enhanced risk of death. Moreover, higher PVS values predicted increased morbidity 16. As previously observed,15 the association between PVS and mortality was ’J-shaped' fashion in this study, consistent with the notion that excessive dehydration or congestion can be detrimental.…”

Prognostic implications of plasma volume status estimates in heart failure with preserved ejection fraction: insights from TOPCAT

“…which is consistent with prior heart failure cohorts. 9,10 While higher natriuretic peptides appeared to drive risk for the composite primary endpoint (Figure 3), higher PVS may have an additive role possibly identifying a higher-risk HFpEF phenotype with plasma volume expansion that has led to haemodynamic decompensation. Interestingly, higher PVS was paradoxically associated with more negative global longitudinal strain, suggesting that while related, there may be an additional uncoupling between systolic dysfunction and plasma volume expansion.…”

“…7 -11 An important limitation of these prior studies is that they either excluded or had partial representation of individuals with heart failure with preserved ejection fraction [HFpEF, left ventricular ejection fraction (LVEF) ≥ 45%], which may be more phenotypically distinct from heart failure with reduced ejection fraction (HFrEF, LVEF < 45%). 9 Therefore, in an effort to clarify the importance of plasma volume status (PVS) in HFpEF, we calculated plasma volume and PVS and determined whether plasma volume expansion was associated with an increased risk of adverse long-term events in an exclusive HFpEF cohort -the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist Trial (TOPCAT).…”

Prognostic Value of Calculated Plasma Volume Status in Patients Admitted for Acute Decompensated Heart Failure ― A Prospective Comparative Study With Other Indices of Plasma Volume ―

“…Several studies have evaluated the prognostic value of formulas for the estimation of PV and PVS in ADHF patients. [14][15][16][17] Using data from the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS), Duarte et al 14 examined the prognostic value of the PV, as estimated by the Strauss, Kaplan, and Hakim formulas. They found that of these 3 formulas, the strongest association was found between the estimated PV variation calculated by the Strauss formula and poor clinical outcome.…”

“…and <12.0 g/dL for females, according to the World Health Organization criteria. 14,17 The left ventricular ejection fraction (LVEF) was measured by echocardiography using a standard technique. 19 Patients were classified according to the Clinical Scenario (CS) classification, based on systolic blood pressure at admission and other symptoms as previously reported.…”