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The regulation and measurement of plasma volume in heart failure

Item Type:Review
Title:The regulation and measurement of plasma volume in heart failure
Creators Name:Kalra, P.R. and Anagnostopoulos, C. and Bolger, A.P. and Coats, A.J.S. and Anker, S.D.
Abstract:Plasma volume, the intravascular portion of the extracellular fluid volume, can be measured using standard dilution techniques with radiolabeled tracer molecules. In healthy persons, plasma volume remains relatively constant as a result of fight regulation by the complex interaction between neurohormonal systems involved in sodium and water homeostasis. Although chronic heart failure (CHF) is characterized by activation of many of these neurohormonal systems, few studies have evaluated plasma volume in this condition under treatment. Untreated edematous decompensated heart failure (HF) is associated with a significant expansion of plasma volume. Patients with stable CHF, receiving conventional therapy, appear to have a contracted plasma volume, a concept that is in contrast to the widely held belief that CHF is associated with long-term hypervolemia. It is likely that significant changes in plasma volume occur during intensification of medical therapy or during transition from the edematous to the stable state. Clinical assessment of plasma volume may be of particular value during treatment in patients with decompensated HF, in whom the plasma volume is contracted despite an increase in total extracellular fluid volume. Under these circumstances, treatment with inotropes or renal vasodilators may be more appropriate than intravenous diuretics alone. Further studies evaluating plasma volume in HF may help to improve our understanding of the pathophysiologic mechanisms occurring in the development and progression of this complex condition.
Keywords:Cytokines, Congestive Heart Failure, Indicator Dilution Techniques, Neurotransmitter Agents, Plasma Volume, Renin-Angiotensin System, Sympathetic Nervous System
Source:Journal of the American College of Cardiology
Page Range:1901-1908
Date:19 June 2002
Official Publication:https://doi.org/10.1016/S0735-1097(02)01903-4
PubMed:View item in PubMed

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