Marked heterogeneity in plasma volume (PV) and red cell mass (RBCM) volume profile is present even in mild heart failure (HF), a recent study suggests, and identifying volume overload which is common in early HF has the potential to help guide therapy in the reduction of HF progression. 46 patients (mean age 61±13 years) with Class I and II systolic HF were evaluated with 28 undergoing repeat evaluations at 1 year. Researchers found:

• There was no difference in average total blood volume (TBV) at baseline between Class I (n=26) and II (n=20) patients and at 1 year of follow-up.
• However, there was marked heterogeneity in PV and RBCM profiles with TBV expansion identified in 46% of the cohort while only 48% had a normal TBV.
• RBCM was common (39%), but a low hemoglobin concentration was accurate in identifying anemia in only 11% of patients.
• RBCM excess was also identified in 20% of the cohort.