Abstract
Intravascular fluid volume expansion is an acute compensatory adaptation in patients (pts) with chronic heart failure (CHF). Data are lacking on the long-term influence of diuretics and ACE-inhibitors on fluid volume in CHF pts. The purpose was to determine the effect of standard CHF pharmacotherapy on plasma volume (PV) and blood volume (BV). PV and BV were measured in 12 CHF pts (62.1±7.1 yrs; 175.2±6.8 cm; 96.2±18.2 kg) with ischemic disease (LVEF<50%; NYHA II/III) and 7 healthy controls (CON)(71.7±5.3 yrs; 177.1±10.8 cm; 84.4±11.7 kg) 3-4 hrs post-prandial and 20 min after supine rest using the Evans Blue Dye dilution technique. Venous blood samples were collected pre-Blue dye infusion and analyzed for hematocrit (Hct) (corrected 4% for trapped plasma and venous to whole body Hct ratio) and hemoglobin (Hb). Hct was 36.6±3.5 and 37.4±1.1% (p>0.05) and Hb was 15.4±1.9 and 16.2±1.4 g/dl (p>0.05) for CHF and CON, respectively. Absolute PV was 3489.3±655.0 and 3728.7±813.2 ml (p>0.05) and absolute BV was 5469.8±1025.4 and 5942.4±1182.2 ml (p>0.05), for CHF and CON, respectively. Relative PV was 34.1±12.9 v. 44.5±9.0 ml/kg(p≤0.05) and relative BV was 58.5±12.3 v. 70.8±12.6 ml/kg(p≤0.05), in CHF and CON, respectively. These data suggest that standard pharmacotherapy, including, diuretics and ACE-inhibitors, may contract PV and BV in CHF pts.
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