Document Detail

Hemodynamic responses to rapid saline loading: the impact of age, sex, and heart failure.
MedLine Citation:
PMID:  23172838     Owner:  NLM     Status:  MEDLINE    
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.
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:
Type:  Clinical Trial; Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Validation Studies     Date:  2012-11-21
Journal Detail:
Title:  Circulation     Volume:  127     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-03     Completed Date:  2013-03-05     Revised Date:  2014-03-19    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  55-62     Citation Subset:  AIM; IM    
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MeSH Terms
Age Factors
Blood Pressure / physiology
Diagnostic Techniques, Cardiovascular / standards*
Heart Failure / diagnosis*,  physiopathology*
Hemodynamics / physiology*
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
Reg. No./Substance:
7647-14-5/Sodium Chloride

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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