| Hemodynamic responses to rapid saline loading: the impact of age, sex, and heart failure. | |
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MedLine Citation:
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PMID: 23172838 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Hemodynamic assessment after volume challenge has been proposed as a way to identify heart failure with preserved ejection fraction. However, the normal hemodynamic response to a volume challenge and how age and sex affect this relationship remain unknown. METHODS AND RESULTS: Sixty healthy subjects underwent right heart catheterization to measure age- and sex-related normative responses of pulmonary capillary wedge pressure and mean pulmonary arterial pressure to volume loading with rapid saline infusion (100-200 mL/min). Hemodynamic responses to saline infusion in heart failure with preserved ejection fraction (n=11) were then compared with those of healthy young (<50 years of age) and older (≥50 years of age) subjects. In healthy subjects, pulmonary capillary wedge pressure increased from 10±2 to 16±3 mm Hg after ~1 L and to 20±3 mm Hg after ~2 L of saline infusion. Older women displayed a steeper increase in pulmonary capillary wedge pressure relative to volume infused (16±4 mm Hg·L(-1)·m(2)) than the other 3 groups (P≤0.019). Saline infusion resulted in a greater increase in mean pulmonary arterial pressure relative to cardiac output in women compared with men regardless of age. Subjects with heart failure with preserved ejection fraction exhibited a steeper increase in pulmonary capillary wedge pressure relative to infused volume (25±12 mm Hg·L(-1)·m(2)) than healthy young and older subjects (P≤0.005). CONCLUSIONS: Filling pressures rise significantly with volume loading, even in healthy volunteers. Older women and patients with heart failure with preserved ejection fraction exhibit the largest increases in pulmonary capillary wedge pressure and mean pulmonary arterial pressure. |
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Authors:
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Naoki Fujimoto; Barry A Borlaug; Gregory D Lewis; Jeffrey L Hastings; Keri M Shafer; Paul S Bhella; Graeme Carrick-Ranson; Benjamin D Levine |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Validation Studies Date: 2012-11-21 |
Journal Detail:
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Title: Circulation Volume: 127 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2013 Jan |
Date Detail:
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Created Date: 2013-01-03 Completed Date: 2013-03-05 Revised Date: 2013-04-16 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 55-62 Citation Subset: AIM; IM |
Affiliation:
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University of Texas Southwestern Medical Center at Dallas. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Age Factors Aged Blood Pressure / physiology Diagnostic Techniques, Cardiovascular / standards* Female Heart Failure / diagnosis*, physiopathology* Hemodynamics / physiology* Humans Male Middle Aged Prospective Studies Pulmonary Wedge Pressure / physiology Reference Values Sex Characteristics Sex Factors Sodium Chloride / administration & dosage*, diagnostic use* Stroke Volume / physiology Ventricular Pressure / physiology Young Adult |
| Grant Support | |
ID/Acronym/Agency:
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AG17479/AG/NIA NIH HHS; R01 AG017479/AG/NIA NIH HHS |
| Chemical | |
Reg. No./Substance:
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7647-14-5/Sodium Chloride |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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