Plasma volume status in patients after Fontan operation: Prognostic value and the associations with Fontan pathophysiology

Background: Assessment of plasma volume status (PVS) is essential for the management of patients with heart failure (HF). We aimed to elucidate the clinical features of PVS in patients with Fontan circulation (FC). Methods: Plasma volume (PV) was measured via pulse dye densitometry (icg-PV) and comp...

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Autores principales:	Hideo Ohuchi, Osamu Sasaki, Yosuke Hayama, Hikari Miike, Kenichi Kurosaki, Isao Shiraishi, Michikazu Nakai, Osamu Yamada
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Fontan Plasma volume status Heart failure Morbidity Mortality Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/a28dc7a7a42743afafd2337ec8b5290e
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spelling	oai:doaj.org-article:a28dc7a7a42743afafd2337ec8b5290e2021-11-06T04:38:04ZPlasma volume status in patients after Fontan operation: Prognostic value and the associations with Fontan pathophysiology2666-668510.1016/j.ijcchd.2021.100219https://doaj.org/article/a28dc7a7a42743afafd2337ec8b5290e2021-10-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2666668521001439https://doaj.org/toc/2666-6685Background: Assessment of plasma volume status (PVS) is essential for the management of patients with heart failure (HF). We aimed to elucidate the clinical features of PVS in patients with Fontan circulation (FC). Methods: Plasma volume (PV) was measured via pulse dye densitometry (icg-PV) and compared with the calculated PV (c-PV) in 114 patients with FC and 32 with biventricular circulation (BVC). We derived the PVS (%) [{(c-PV－ideal-PV)/ideal-PV} × 100] and elucidated its clinical associations in 275 consecutive patients with FC and 493 with BVC. Results: The c-PV correlated with the icg-PV in FC (r = 0.70) and BVC (r = 0.67) (p < 0.0001 for each). Compared with BVC, FC exhibited contracted c-PV (37 ± 5 vs. 39 ± 4 mL/kg) and the PVS was lower (−4.7% ± 11.5% vs. −1.3% ± 9.8%), although the circulating blood volume (BV) was greater (69 ± 6 vs. 66 ± 5 mL/kg) (p < 0.0001 for all). Increased PVS was independently associated with HF-associated hospitalization and all-cause mortality in both groups (p < 0.05) with a cutoff value of 3.0% for FC. FC with PVS ≥3.0% (n = 59) was characterized by low aortic pressure, high cardiac index, and large ventricular volume with a high prevalence of protein-losing enteropathy (p < 0.05–0.0001). Conclusions: Compared with BVC, FC was associated with increased BV but contracted PV. Regarding Fontan, a higher PVS is associated with a phenotype of high output HF and higher risk of adverse outcomes.Hideo OhuchiOsamu SasakiYosuke HayamaHikari MiikeKenichi KurosakiIsao ShiraishiMichikazu NakaiOsamu YamadaElsevierarticleFontanPlasma volume statusHeart failureMorbidityMortalityDiseases of the circulatory (Cardiovascular) systemRC666-701ENInternational Journal of Cardiology Congenital Heart Disease, Vol 5, Iss , Pp 100219- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Fontan Plasma volume status Heart failure Morbidity Mortality Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Fontan Plasma volume status Heart failure Morbidity Mortality Diseases of the circulatory (Cardiovascular) system RC666-701 Hideo Ohuchi Osamu Sasaki Yosuke Hayama Hikari Miike Kenichi Kurosaki Isao Shiraishi Michikazu Nakai Osamu Yamada Plasma volume status in patients after Fontan operation: Prognostic value and the associations with Fontan pathophysiology
description	Background: Assessment of plasma volume status (PVS) is essential for the management of patients with heart failure (HF). We aimed to elucidate the clinical features of PVS in patients with Fontan circulation (FC). Methods: Plasma volume (PV) was measured via pulse dye densitometry (icg-PV) and compared with the calculated PV (c-PV) in 114 patients with FC and 32 with biventricular circulation (BVC). We derived the PVS (%) [{(c-PV－ideal-PV)/ideal-PV} × 100] and elucidated its clinical associations in 275 consecutive patients with FC and 493 with BVC. Results: The c-PV correlated with the icg-PV in FC (r = 0.70) and BVC (r = 0.67) (p < 0.0001 for each). Compared with BVC, FC exhibited contracted c-PV (37 ± 5 vs. 39 ± 4 mL/kg) and the PVS was lower (−4.7% ± 11.5% vs. −1.3% ± 9.8%), although the circulating blood volume (BV) was greater (69 ± 6 vs. 66 ± 5 mL/kg) (p < 0.0001 for all). Increased PVS was independently associated with HF-associated hospitalization and all-cause mortality in both groups (p < 0.05) with a cutoff value of 3.0% for FC. FC with PVS ≥3.0% (n = 59) was characterized by low aortic pressure, high cardiac index, and large ventricular volume with a high prevalence of protein-losing enteropathy (p < 0.05–0.0001). Conclusions: Compared with BVC, FC was associated with increased BV but contracted PV. Regarding Fontan, a higher PVS is associated with a phenotype of high output HF and higher risk of adverse outcomes.
format	article
author	Hideo Ohuchi Osamu Sasaki Yosuke Hayama Hikari Miike Kenichi Kurosaki Isao Shiraishi Michikazu Nakai Osamu Yamada
author_facet	Hideo Ohuchi Osamu Sasaki Yosuke Hayama Hikari Miike Kenichi Kurosaki Isao Shiraishi Michikazu Nakai Osamu Yamada
author_sort	Hideo Ohuchi
title	Plasma volume status in patients after Fontan operation: Prognostic value and the associations with Fontan pathophysiology
title_short	Plasma volume status in patients after Fontan operation: Prognostic value and the associations with Fontan pathophysiology
title_full	Plasma volume status in patients after Fontan operation: Prognostic value and the associations with Fontan pathophysiology
title_fullStr	Plasma volume status in patients after Fontan operation: Prognostic value and the associations with Fontan pathophysiology
title_full_unstemmed	Plasma volume status in patients after Fontan operation: Prognostic value and the associations with Fontan pathophysiology
title_sort	plasma volume status in patients after fontan operation: prognostic value and the associations with fontan pathophysiology
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/a28dc7a7a42743afafd2337ec8b5290e
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Plasma volume status in patients after Fontan operation: Prognostic value and the associations with Fontan pathophysiology

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