The Relation Between Venous Reserve Capacity and Low Plasma Volume

Krabbendam, Ineke; Janssen, Ben J. A.; Dijk, Arie P.J. van; Jongsma, H.W.; Oyen, Wim J.G.; Lotgering, F.K.; Spaanderman, Marc E. A.

doi:10.1177/1933719108316983

Cited by 12 publications

(11 citation statements)

References 30 publications

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“…This idea is supported by observations that, in the follicular phase, formerly PE women with subnormal plasma volume do not show elevated levels of renin-angiotensin-aldosterone system components, epinephrine or norepinephrine, compared with normal parous controls 61 . Additionally, a higher rate of presyncope under orthostatic stress in formerly PE women, and reduced venous compliance and capacitance have been observed compared with women with normal plasma volume 55,57,69 . The supposed reduced size of the venous compartment may originate from an individual's reduced fetal growth, consistent with the theory of developmental origins of adult disease, increased venous tone to compensate for conditions of increasing arterial demand, attenuated vessel reactivity or autonomic dysfunction 70 .…”

Section: Discussionmentioning

confidence: 99%

Physiological adaptation of maternal plasma volume during pregnancy: a systematic review and meta-analysis

Haas

Ghossein‐Doha

Kuijk

et al. 2017

Ultrasound Obstet Gynecol

184

132

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Section: Discussionmentioning

confidence: 99%

Physiological adaptation of maternal plasma volume during pregnancy: a systematic review and meta-analysis

Haas

Ghossein‐Doha

Kuijk

et al. 2017

Ultrasound Obstet Gynecol

184

132

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“…preconceptual and preclinical phase of preeclampsia [18,47,48]. Low plasma volume is also associated to reduce venous reserve capacity in preeclampsia [18].…”

Section: Arterial and Venous Systemmentioning

confidence: 99%

Maternal cardiac function in preeclampsia

Melchiorre

Thilaganathan

2011

Current Opinion in Obstetrics &Amp; Gynecology

103

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Preeclampsia is associated with stage B heart failure (asymptomatic left ventricular dysfunction/hypertrophy), a high prevalence of essential hypertension and an increased cardiovascular risk status within few years postpartum. These findings are more prevalent with early onset/preterm preeclampsia. These cardiovascular findings are consistent with epidemiological studies showing a 'dose-dependent' relationship between preeclampsia and long-term cardiovascular morbidity and mortality. There is increasing evidence supporting the concept that a history of early onset/preterm preeclampsia should be taken into account to identify women at high cardiovascular risk even in the absence of other concomitant risk factors.

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“…Previous studies demonstrated that formerly PE women at rest have low venous reserve, characterized by low PV, low VeC, and high sympathetic tone. 10 Aerobic exercise is perhaps the best intervention to improve venous reserve. It increases PV and reduces sympathetic tone in healthy individuals.…”

mentioning

confidence: 99%

Aerobic Exercise Training in Formerly Preeclamptic Women

et al. 2015

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Women with a history of preeclampsia are at increased risk of recurrent gestational hypertensive disease and cardiovascular disease later in life.1,2 Fifty percent of formerly preeclamptic women (formerly PE women) have low plasma volume (PV) 3 and the recurrence risk of preeclampsia varies inversely with PV. 4 In pregnancy, a marked PV expansion (+30% to 60%) is required to meet the physiological demands of advanced pregnancy. 5,6 Formerly PE women with low PV show reduced PV expansion in pregnancy, which suggests that the adaptive capacity of the venous system in these women is limited.7 When PV expansion cannot meet the physiological demands, the circulation may compensate for it by an increase in sympathetic activity. 7 The resulting lowvolume high-output circulation will exert extra shear stress on the endothelium. 3,7 This may set the stage for endothelial dysfunction, vascular damage, and hypertensive disease in pregnancy and later in life.The venous compartment is the most prominent blood volume reservoir of the body. Although at rest two-thirds of PV is localized in the venous system, it can be rapidly mobilized by sympathetic-mediated venoconstriction in times of increased arterial demands, including pregnancy and exercise. 8,9 Venous capacity is largely determined by venous compliance (VeC) and varies dynamically with sympathetic tone predominantly controlled by the baroreflex system. 8 Dynamic changes in VeC can be tested through orthostatic stress testing. Previous studies demonstrated that formerly PE women at rest have low venous reserve, characterized by low PV, low VeC, and high sympathetic tone. 10Aerobic exercise is perhaps the best intervention to improve venous reserve. It increases PV and reduces sympathetic tone in healthy individuals. 11,12 In formerly PE women with low PV, aerobic exercise training could help to normalize venous reserve and thereby reduce the risk of hypertensive disease in future pregnancy and later in life. The extent to which formerly PE women are able to improve their venous reserve by exercise training is unknown. Our study addresses the question to what extent an aerobic exercise training program Abstract-In women with a history of preeclampsia, low plasma volume (≤1373 mL/m 2 ) is associated with recurrent preeclampsia and chronic hypertension. Interventions that improve volume reserve may reduce these risks in formerly preeclamptic women. In this study, we examined the effects of aerobic exercise training on venous reserves in 24 normotensive formerly preeclamptic women and 20 controls. Before and after 12-week aerobic exercise training, we measured plasma volume with albumin indicator dilution technique and venous compliance with venous occlusion plethysmography. Venous compliance and hemodynamic responses were assessed dynamically during graded head-up tilt (HUT). Formerly preeclamptic women had lower pretraining plasma volume and venous compliance than controls (1348±78 versus 1529±112 mL/m ; P<0.01, respectively). Blood pressure decreased comparably between...

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The Relation Between Venous Reserve Capacity and Low Plasma Volume

Abstract: LPV decreases the capacity to cope with head-up tilt without affecting the response pattern, suggesting reduced VRC.

Cited by 12 publications

References 30 publications

Physiological adaptation of maternal plasma volume during pregnancy: a systematic review and meta-analysis

Physiological adaptation of maternal plasma volume during pregnancy: a systematic review and meta-analysis

Maternal cardiac function in preeclampsia

Aerobic Exercise Training in Formerly Preeclamptic Women

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