Increased Red Cell Volume Is a Relevant Contributing Factor to an Expanded Blood Volume in Compensated Systolic Chronic Heart Failure

Ahlgrim, Christoph; Birkner, Philipp; Seiler, Florian; Wrobel, Nina; Grundmann, Sebastian; Bode, Christoph; Pottgießer, Torben

doi:10.1016/j.cardfail.2019.11.025

Cited by 17 publications

(37 citation statements)

References 37 publications

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“…9 Interestingly, similar data are obtained despite application of different techniques for BV assessment being radioactively labelled albumin 9 and a CO rebreathing method supporting the validity of the data. As observed by our group in a larger cross-sectional study, 5 there was no clear association between NYHA class and volume status in the tested patients.…”

Section: Discussionsupporting

confidence: 58%

“…Time course of blood volume in CHF As serum creatinine is inversely associated with the change in the excess PV in this set of compensated patients, it supports the concept that a certain degree of PV expansion may ensure kidney function and the compensated state. 10 In this context, a change in PV excess above expected normal values was correlated with RCV excess, which was assumed to be another compensatory mechanism for decreased cardiac output 5 and can be found in up to 66% of patients. 3,5,11 From a clinician's standpoint, it is worth mentioning that the clinical course was stable despite individually increased or decreased BVs.…”

Section: Discussionmentioning

confidence: 99%

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Time course of red cell volume and plasma volume over six months in compensated chronic heart failure

et al. 2021

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Background In patients with chronic heart failure (CHF), volume overload is usually described as an expansion of plasma volume (PV). Additional red cell volume (RCV) expansion also occurs in a relevant fraction of compensated CHF patients. So far, little is known about the stability of these vascular volumes and possible volume excess in compensated CHF patients over time. Methods and results This study aims at quantification of blood volume and its components, RCV and PV (raw values and adjusted for sex and anthropometric characteristics, expressed as per cent of the expected normal value), using an abbreviated carbon monoxide (CO) rebreathing method (aCORM) in 14 patients (two women) with systolic CHF at baseline and at a follow-up visit after approximately 6 months. While a vast heterogeneity was observed concerning RCV (82% to 134% of normalized alues) and PV (72% to 131% of normalized values), the vascular volumes showed a mean change of 1.2% and À1.3% after a mean follow-up of 183 days. Conclusions The vascular volumes including individual volume excess appear to be stable in compensated CHF patients. The reason for this individual volume response concerning both RCV and PV in CHF remains unclear and deserves further clarification.

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Time course of red cell volume and plasma volume over six months in compensated chronic heart failure

et al. 2021

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“…As an analogy, applying aCORM in a group of CHF patients with reduced EF in our laboratory [ 11 ], an average PV (corrected for BSA) of 2069 ± 400 ml/m 2 was found compared to 1919 ± 208 ml/m 2 in this study demonstrating an about 8% lower PV in HTX compared to CHF. It could be hypothesized that over time, the pathophysiologic BV regulations known in CHF are no longer active after heart transplantation.…”

Section: Discussionsupporting

confidence: 51%

“…As CO rebreathing allowed a detection of the withdrawal of small quantities of blood it can be considered as precise [ 17 , 31 ] and less time consuming compared to radiolabeling techniques [ 26 , 32 ]. Its application was safely possible in several groups of patients with anemia [ 26 ], coronary artery disease [ 27 ], chronic heart failure [ 11 , 28 ], liver disease [ 33 ] as well as in the preoperative setting [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

“…True anemia in the sense of a reduced red cell volume (RCV) below normal is also possible [ 10 ]. Reflecting on the complex pathophysiology, our group recently described an increased RCV as a “relevant contributing factor to hypervolemia in addition to an expanded PV in compensated chronic heart failure with reduced ejection fraction (EF)” [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Blood volume and hemoglobin mass in long-term heart transplant recipients with and without Anemia

Seiler

Ahlgrim

Birkner

et al. 2021

J Cardiothorac Surg

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Background In systolic chronic heart failure, a heterogeneous blood volume (BV) regulation can be found with plasma volume expansion in many cases, possibly leading to pseudoanemia. Little is known about the volume status after heart transplantation (HTX). So far, anemia of HTX recipients was solely investigated using hemoglobin-concentration that may be misleading in a clinical context. The objective of the study was whether a difference in plasma volume and red cell volume can be observed in clinically stable heart transplant recipients compared to matched control subjects. Secondary, the aim was to describe anemia in the long-term after HTX based on quantitative data. Methods Blood volume and its constituents red cell volume and plasma volume were quantified using an abbreviated carbon monoxide rebreathing method (aCORM) with focus on its primary measure total hemoglobin mass (Hbmass) and coincidental anemia in 36 (7 women) heart transplant recipients. For comparison, a matched control group of 46 (5 women) healthy subjects was selected. Results Neither Hbmass nor blood volumes were significantly different in HTX patients compared to matched healthy control group subjects. The prevalence of anemia 6.3 ± 4.3 years after transplantation was 19%. Hbmass and red cell volume were significantly lower in anemic HTX patients compared to non-anemic patients while plasma volume was not expanded. Various immunosuppressant regimens did not have an effect on Hbmass, plasma volume or red cell volume. Conclusions There was no difference in blood volumes and Hbmass between HTX patients and control subjects. The pathophysiologic blood volume regulation in chronic heart failure does not seem to be longer active in long-term HTX recipients. However, in the long-term after HTX, anemia occurs in a considerable number of patients as true anemia without a clear association with immunosuppression. Trial registration German registry for clinical studies, DRKS00006078. Registered 09 May 2014, https://www.drks.de/drks_web/navigate.do?navigationId=trial. HTML&TRIAL_ID=DRKS00006078.

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Clinical importance of distinguishing true anemia from dilutional pseudo‐anemia: Consequences of a 3‐year follow‐up volume assessment in a heart failure patient

Increased Red Cell Volume Is a Relevant Contributing Factor to an Expanded Blood Volume in Compensated Systolic Chronic Heart Failure

Cited by 17 publications

References 37 publications

Time course of red cell volume and plasma volume over six months in compensated chronic heart failure

Time course of red cell volume and plasma volume over six months in compensated chronic heart failure

Blood volume and hemoglobin mass in long-term heart transplant recipients with and without Anemia

Clinical importance of distinguishing true anemia from dilutional pseudo‐anemia: Consequences of a 3‐year follow‐up volume assessment in a heart failure patient

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