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Document Details :
Title: Subclinical volume overload in stable outpatients with chronic heart failure
Author(s): L. Boonen , F.H. Verbrugge , P. Nijst , P. Noyens , P. De Vusser , D. Verhaert , J. Van Lierde , M. Vrolix , M. Dupont , W. Mullens
Journal: Acta Cardiologica
Volume: 71 Issue: 3 Date: 2016
Objective: The objective of this study was to characterize stable outpatients with subclinical volume overload in chronic heart failure (CHF) by using bioelectrical impedance analysis (BIA) measurements.
Methods and results: Venous blood sampling and BIA were performed in consecutive CHF patients (n = 58) free from clinical signs of volume overload and treated with oral loop diuretics. Subclinical volume overload was defined as excess extracellular water on BIA. Patients with (n = 34) versus without (n = 24) subclinical volume overload were significantly older (72 ± 10 versus 65 ± 9 years; P-value = 0.016), had higher systolic blood pressure (126 ± 20 versus 114 ± 17 mmHg; P-value = 0.012), and took angiotensin-converting enzyme inhibitors more often (65% versus 33%; P-value = 0.032). Dyspnoea symptoms were similar among both groups. Subclinical volume overload was associated with low serum albumin (P-value = 0.014) and protein levels (P-value = 0.041). In contrast, serum sodium levels (141 ± 3 versus 139 ± 2 mEq/L; P-value = 0.033) but not chloride levels (99 ± 14 versus 101 ± 3 mEq/L; P-value = 0.980) were significantly higher in patients with versus without subclinical volume overload, respectively. The former versus latter group also demonstrated lower plasma aldosterone levels [276 (195-475) versus 400 (306-717) ng/L, respectively; P-value = 0.032].
Conclusions: Subclinical volume overload assessed by BIA in stable CHF is associated with low serum protein levels, increased serum sodium but not serum chloride, as well as decreased neurohumoral activation.