Impact of plasma volume redistribution on outcomes in patients with heart failure with reduced ejection fraction

Abstract Funding Acknowledgements Type of funding sources: None. Background The impact capacitance and blood volume redistribution on outcomes patients with chronic heart failure is incompletely understood. Quantitative plasma (PV) measurements together echocardiographic evaluation allow a comprehensive assessment the interplay between volumetric overload, cardiac chamber remodelling myocardial function. Purpose We hypothesize that PV expansion associated renal dysfunction, right ventricular-pulmonary arterial uncoupling unfavorable in HF reduced ejection fraction (HFrEF). Methods Patients hospitalized at Mayo Clinic decompensated who had by indicator-dilution nuclear methodology (Daxor BVA100) were included. considered hypervolemic if BV was ≥25% over expected. primary endpoint composite all-cause mortality or transplantation. closest TTE to time used measure various indexes performance (standard echo parameters global chamber-specific strain parameters). Event-free survival estimated using Kaplan-Meier method. relationship evaluated correlation coefficient (r²). Results A total 65 enrolled study. Reduced LVEF present 53 (81.6%) patients. There 44 events (32 deaths, 12 transplants) after median follow-up 43 months (IQR 14–65). HFrEF are presented Table. Our main findings were: 1) an increased risk adverse (Figure 1); 2) Volume correlated function, suggesting overload remodeling may be responsible for altered mechanics 2); 3) triggered expansion, causes postcapillary pulmonary hypertension; 4) also dysfunction increasing level protein catabolism (Table 1). Conclusion Expansion left atrium dilatation, abnormal filling both atria ventricular dilatation / dysfunction. Plasma redistributions apparently became trigger stimulated hypertension, outcomes.