title: Plasma Volume Is Normal but Heterogeneously Distributed, and True Anemia Is Highly Prevalent in Patients With Stable Heart Failure.
abstract: BACKGROUND
  Intravascular volume overload and depletion as well as anemia are associated with increased hospital admissions and mortality in patients with heart failure. This study aimed to accurately measure plasma volume and red cell mass (RCM) in stable patients with chronic heart failure with reduced ejection fraction (HFrEF) and gain more insight into plasma volume regulation and anemia in stable conditions of HFrEF.
  
  
  RESULTS
  Plasma volume and RCM measurement based on99Tc-labeled red blood cells, venous blood sample,s and clinical parameters were obtained in 24 stable HFrEF patients under optimal medical therapy. Measured plasma volume values were compared with predicted values based on body surface area. Plasma volume was on average normal (99.98% of predicted) but heterogeneously distributed (variations of 81%-133%). Neurohumoral activation and medication use were not associated with plasma volume status. Furthermore, anemia based on actual measurement of RCM was present in up to 75% of subjects, but rarely hemodilutional.
  
  
  CONCLUSIONS
  In stable chronic HFrEF patients under optimal medical therapy, plasma volume is overall normal but heterogeneously distributed. Anticipated factors such as neurohumoral activation and heart failure medication were not associated with plasma volume. Furthermore, anemia is more common than as assessed by hemoglobin.
authors: Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium; Doctoral School for Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.
authors: Petra
authors: P
authors: Nijst
authors: Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium.
authors: Frederik H
authors: FH
authors: Verbrugge
authors: Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium; Doctoral School for Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.
authors: Philippe B
authors: PB
authors: Bertrand
authors: Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium.
authors: Pieter
authors: P
authors: Martens
authors: Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium.
authors: Matthias
authors: M
authors: Dupont
authors: Department of Nuclear Medicine, Ziekenhuis Oost-Limburg, Genk, Belgium.
authors: Olivier
authors: O
authors: Drieskens
authors: Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.
authors: Joris
authors: J
authors: Penders
authors: Department of Cardiovascular Medicine, Cleveland Clinic, Heart and Vascular Institute, Cleveland, Ohio.
authors: W H Wilson
authors: WH
authors: Tang
authors: Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium; Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium. Electronic address: wilfried.mullens@zol.be.
authors: Wilfried
authors: W
authors: Mullens
mesh_terms: D000368:Aged; D000740:Anemia / Q000097:blood* / Q000453:epidemiology* / Q000503:physiopathology; D002908:Chronic Disease; D015331:Cohort Studies; D015897:Comorbidity; D004911:Erythrocyte Volume; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood* / Q000453:epidemiology* / Q000503:physiopathology; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D010953:Plasma Volume / Q000502:physiology*; D015995:Prevalence; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D013318:Stroke Volume / Q000502:physiology*; D016019:Survival Analysis; D013997:Time Factors
chemical_list: D006454:Hemoglobins
keywords: Plasma volume; anemia; stable heart failure