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Association of estimated plasma volume status with hemodynamic and echocardiographic parameters

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Abstract

Background

Estimated plasma volume status (ePVS) has diagnostic and prognostic value in patients with heart failure (HF). However, it remains unclear which congestion markers (i.e., biological, imaging, and hemodynamic markers) are preferentially associated with ePVS. In addition, there is evidence of sex differences in both the hematopoietic process and myocardial structure/function.

Method and results

Patients with significant dyspnea (NYHA ≥ 2) underwent echocardiography and lung ultrasound within 4 h prior to cardiac catheterization. Patients were divided according to tertiles based on sex-specific ePVS thresholds calculated from hemoglobin and hematocrit measurements using Duarte’s formula. Among the 78 included patients (median age 74.5 years; males 69.2%; HF 48.7%), median ePVS was 4.1 (percentile25–75 = 3.7–4.9) mL/g in males (N = 54) and 4.8 (4.4–5.3) mL/g in females (N = 24). Patients with the highest ePVS had more frequently HF, higher NT-proBNP, larger left atrial volume, and higher E/e’ (all p values < 0.05), but no difference in inferior vena cava diameter or pulmonary congestion assessed by lung ultrasound (all p values > 0.10). In multivariable analysis, higher E/e’ and lower diastolic blood pressure were significantly associated with increased ePVS. The association between ePVS and congestion variables was not sex-dependent except for left-ventricular end-diastolic pressure, which was only correlated with ePVS in females (Spearman Rho = 0.53, p < 0.01 in females and Spearman Rho = − 0.04, p = 0.76 in males; pinteraction = 0.08).

Conclusion

ePVS is associated with E/e’ regardless of sex, while only associated with invasively measured left-ventricular end-diastolic pressure in females. These results suggest that ePVS is preferably associated with left-sided hemodynamic markers of congestion.

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Acknowledgements

The Nancy team is supported by the RHU Fight-HF, a public grant overseen by the French National Research Agency (ANR) as part of the second “Investissements d’Avenir” program (reference: ANR-15-RHUS-0004), by the French PIA project “Lorraine Université d’Excellence” (reference: ANR-15-IDEX-04-LUE), the ANR FOCUS-MR (reference: ANR-15-CE14-0032-01), ERA-CVD EXPERT (reference: ANR-16-ECVD-0002-02), Contrat de Plan Etat Lorraine IT2MP and FEDER Lorraine.

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Authors and Affiliations

  1. INSERM, Centre d’Investigations Cliniques 1433, CHRU de Nancy, Inserm 1116 and INI-CRCT (Cardiovascular and Renal Clinical Trialists) F-CRIN Network, Université de Lorraine, 4, rue du Morvan, 54500, Vandoeuvre-Les-Nancy, France

    Masatake Kobayashi, Olivier Huttin, Kevin Duarte, Patrick Rossignol & Nicolas Girerd

  2. Service de Cardiologie Et Maladies Vasculaires Et CIC-IT 1414, CHU Rennes, 35000, Rennes, France

    Erwan Donal, Arnaud Hubert, Hervé Le Breton, Elena Galli, Maxime Fournet, Philippe Mabo, Frederic Schnell & Christophe Leclercq

  3. Université de Rennes 1, LTSI, 35000, Rennes, France

    Erwan Donal, Arnaud Hubert, Hervé Le Breton, Elena Galli, Maxime Fournet, Philippe Mabo, Frederic Schnell & Christophe Leclercq

  4. INSERM, U1099, 35000, Rennes, France

    Erwan Donal, Arnaud Hubert, Hervé Le Breton, Elena Galli, Maxime Fournet, Philippe Mabo & Christophe Leclercq

  5. Service de Médicine du Sport, CHU Rennes, 35000, Rennes, France

    Frederic Schnell

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  1. Masatake Kobayashi
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  2. Olivier Huttin
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Correspondence to Nicolas Girerd.

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Conflict of interest

N.G. reports honoraria from Novartis and Boehringer. P.R. reports grants and personal fees from AstraZeneca, grants and personal fees from Bayer, grants and personal fees from CVRx, personal fees from Fresenius, grants and personal fees from Novartis, personal fees from Grunenthal, personal fees from Servier, personal fees from Stealth Peptides, personal fees from Vifor Fresenius Medical Care Renal Pharma, personal fees from Idorsia, personal fees from NovoNordisk, personal fees from Ablative Solutions, personal fees from G3P, personal fees from Corvidia, personal fees from Relypsa, outside the submitted work; and Cofounder: CardioRenal, a company developing a telemonitoring loop in heart failure (including potassium measurements). All other authors have no conflicts to disclose.

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Kobayashi, M., Huttin, O., Donal, E. et al. Association of estimated plasma volume status with hemodynamic and echocardiographic parameters. Clin Res Cardiol 109, 1060–1069 (2020). https://doi.org/10.1007/s00392-020-01599-9

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