Division of Cardiology, Department of Medicine, Duke University, Durham, North Carolina, USA; Duke Clinical Research Institute, Durham, North Carolina, USA.
Department of Cardiology Alfred Hospital and Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.
J Am Coll Cardiol. 2022 May 10;79(18):1858-1869. doi: 10.1016/j.jacc.2022.02.050.
A number of pathologic processes contribute to the elevation in cardiac filling pressures in heart failure (HF), including myocardial dysfunction and primary volume overload. In this review, we discuss the important role of the venous system and the concepts of stressed blood volume and unstressed blood volume. We review how regulation of venous tone modifies the distribution of blood between these 2 functional compartments, the physical distribution of blood between the pulmonary and systemic circulations, and how these relate to the hemodynamic abnormalities observed in HF. Finally, we review recently applied methods for estimating stressed blood volume and how they are being applied to the results of clinical studies to provide new insights into resting and exercise hemodynamics and therapeutics for HF.
许多病理过程导致心力衰竭（HF）中心脏充盈压升高，包括心肌功能障碍和原发性容量超负荷。在这篇综述中，我们讨论了静脉系统的重要作用以及应激血容量和非应激血容量的概念。我们回顾了静脉张力调节如何改变这两个功能隔室之间的血液分布、肺循环和体循环之间血液的物理分布，以及这些如何与 HF 中观察到的血流动力学异常相关。最后，我们回顾了最近用于估计应激血容量的方法，以及它们如何应用于临床研究结果，为 HF 的静息和运动血流动力学以及治疗提供新的见解。
