Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
Glob Heart. 2022 Aug 25;17(1):60. doi: 10.5334/gh.1136. eCollection 2022.
Plasma volume (PV) expansion hallmarks the syndrome of heart failure (HF) but is difficult to be quantified noninvasively. Estimated plasma volume status (ePVS) has marked prognostic utility in the failing left heart, however its use in right heart failure (RHF) remains unknown. This study aims to investigate the prognostic value of ePVS among isolated RHF patients.
We retrospectively collected 208 patients admitted for RHF in our hospital from the electronic database from 2017 to 2019. ePVS was calculated using the Hakim formula. Patients were divided into low and high groups based on their PV value. Logistic regression was used to compare the odds of in-hospital mortality between these groups.
The overall in-hospital mortality was 12.5%, tripled from the low group to the high group (6.7% vs. 18.3%), within a median of 6 (3-19) days. High ePVS significantly predicted mortality in RHF, even after being adjusted for demographic, hemodynamic, chemistry, and medication variables (adjusted OR: 5.83, 95% CI: 1.62-20.95, < 0.01).
ePVS is associated with in-hospital mortality among isolated RHF patients. Given not only the wide accessibility of hemogram but also the low cost and the rapid quantification of relative PV, this simple tool can potentially aid in optimizing RHF management, especially in rural area, although further evaluation is warranted.
血浆容量（PV）扩张是心力衰竭（HF）综合征的标志，但很难进行非侵入性定量。估计的血浆容量状态（ePVS）在心衰左心具有显著的预后作用，然而其在右心衰竭（RHF）中的应用尚不清楚。本研究旨在探讨 ePVS 在孤立性 RHF 患者中的预后价值。
我们回顾性地从 2017 年至 2019 年的电子数据库中收集了 208 名因 RHF 住院的患者。使用 Hakim 公式计算 ePVS。根据 PV 值将患者分为低组和高组。使用逻辑回归比较两组住院期间死亡率的比值比。
总体住院死亡率为 12.5%，从低组到高组翻了三倍（6.7%比 18.3%），中位数为 6（3-19）天。即使在调整了人口统计学、血流动力学、化学和药物变量后，高 ePVS 仍能显著预测 RHF 患者的死亡率（调整后的比值比：5.83，95%CI：1.62-20.95， < 0.01）。
ePVS 与孤立性 RHF 患者的住院期间死亡率相关。鉴于血常规不仅广泛可用，而且成本低、相对 PV 快速定量，这种简单的工具可能有助于优化 RHF 管理，特别是在农村地区，尽管需要进一步评估。
