{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T20:31:26Z","timestamp":1790022686263,"version":"4.0.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"vor","delay-in-days":1458,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2021,12,8]],"date-time":"2021-12-08T00:00:00Z","timestamp":1638921600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"FAST BioMedical"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>In acute heart failure (AHF), changes of venous haemoglobin (Hb) concentrations, haematocrit (Hct), and estimated plasma volume (ePV) have been proposed as surrogates of decongestion. These estimates are based on the theoretical assumptions that changes of Hb concentrations and Hct are driven by the intravascular volume status and that the intravascular Hb pool remains stable. The objective of this study was to assess the relationship of changes of measured plasma volume (mPV) with changes of Hb, Hct, and ePV in AHF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We studied 36 AHF patients, who received two sequential assessments of mPV, measured red cell volume (mRCV) and measured total blood volume (mTBV) (48 h apart), during the course of diuretic therapy using a novel visible fluorescent injectate (VFI) technique based on the indicator dilution principle. Changes of ePV were calculated based on the Kaplan\u2013Hakim or Strauss formula. AHF patients receiving diuretics (median intravenous furosemide equivalent 160 mg\/48 h) displayed a wide range of changes of mPV (\u221225.4% to +37.0%). Changes in mPV were not significantly correlated with changes of Hb concentration [Pearson's r (r) = \u22120.241, P = 0.157], Hct (r = \u22120.307, P = 0.069), ePVKaplan\u2013Hakim (r = 0.228, P = 0.182), or ePVStrauss (r = 0.237, P = 0.163). In contrast to theoretical assumptions, changes of mTBV were poorly correlated with changes of Hb concentrations and some patients displayed unanticipated variability of mRCV, suggesting an unstable intravascular red cell pool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Changes of Hb or Hct were not reflective of directly measured changes of intravascular volume status in AHF patients. Basing clinical assessment of decongestion on changes of Hb or Hct may misguide clinical decision-making on an individual patient level.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.13739","type":"journal-article","created":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T01:40:45Z","timestamp":1639014045000},"page":"66-76","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Discordance Between Estimated and Measured Changes in Plasma Volume Among Patients with Acute Heart Failure"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8313-0200","authenticated-orcid":false,"given":"Jutta S.","family":"Swolinsky","sequence":"first","affiliation":[{"name":"Department of Nephrology and Medical Intensive Care, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Hindenburgdamm 30, Berlin, 12203 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enkhtuvshin","family":"Tuvshinbat","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Medical Intensive Care, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Hindenburgdamm 30, Berlin, 12203 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Leistner","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiology, Campus Benjamin Franklin, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin ,","place":["Germany"]},{"name":"Berlin Institute of Health at Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin , Berlin ,","place":["Germany"]},{"name":"DZHK (German Centre for Cardiovascular Research), partner site Berlin , Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Edelmann","sequence":"additional","affiliation":[{"name":"Berlin Institute of Health at Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin , Berlin ,","place":["Germany"]},{"name":"DZHK (German Centre for Cardiovascular Research), partner site Berlin , Berlin ,","place":["Germany"]},{"name":"Department of Internal Medicine and Cardiology, Campus Virchow Klinikum, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Knebel","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Campus Mitte, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niklas P.","family":"Nerger","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Medical Intensive Care, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Hindenburgdamm 30, Berlin, 12203 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Lemke","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Medical Intensive Care, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Hindenburgdamm 30, Berlin, 12203 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Roehle","sequence":"additional","affiliation":[{"name":"Berlin Institute of Health at Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin , Berlin ,","place":["Germany"]},{"name":"Institute of Biometry and Clinical Epidemiology, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin ,","place":["Germany"]},{"name":"Clinical Study Center, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Haase","sequence":"additional","affiliation":[{"name":"Medical Faculty, Otto von-Guericke-University Magdeburg , Magdeburg ,","place":["Germany"]},{"name":"Diaverum Renal Care Center , Potsdam ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Rosa","family":"Costanzo","sequence":"additional","affiliation":[{"name":"Advocate Heart Institute , Naperville, IL ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geraldine","family":"Rauch","sequence":"additional","affiliation":[{"name":"Institute of Biometry and Clinical Epidemiology, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veselin","family":"Mitrovic","sequence":"additional","affiliation":[{"name":"Kerckhoff Klinik , Bad Nauheim ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edis","family":"Gasanin","sequence":"additional","affiliation":[{"name":"Kerckhoff Klinik , Bad Nauheim ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Meier","sequence":"additional","affiliation":[{"name":"FAST BioMedical , Indianapolis, IN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter A.","family":"McCullough","sequence":"additional","affiliation":[{"name":"Cardiorenal Society of America , Phoenix, AZ ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai-Uwe","family":"Eckardt","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Medical Intensive Care, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Hindenburgdamm 30, Berlin, 12203 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce A.","family":"Molitoris","sequence":"additional","affiliation":[{"name":"FAST BioMedical , Indianapolis, IN ,","place":["USA"]},{"name":"Indiana University , Indianapolis, IN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7700-7142","authenticated-orcid":false,"given":"Kai M.","family":"Schmidt-Ott","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Medical Intensive Care, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Hindenburgdamm 30, Berlin, 12203 ,","place":["Germany"]},{"name":"Berlin Institute of Health at Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin , Berlin ,","place":["Germany"]},{"name":"Max Delbr\u00fcck Center for Molecular Medicine in the Helmholtz Association , Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,12,8]]},"reference":[{"key":"2026012114184706000_ehf213739-bib-0001","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1161\/CIRCHEARTFAILURE.111.963413","article-title":"Is worsening renal function an ominous prognostic sign in patients with acute heart failure? The role of congestion and its interaction with renal function","volume":"5","author":"Metra","year":"2012","journal-title":"Circ Heart Fail"},{"key":"2026012114184706000_ehf213739-bib-0002","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.jchf.2017.09.023","article-title":"Integrative assessment of congestion in heart failure throughout the patient journey","volume":"6","author":"Girerd","year":"2018","journal-title":"JACC Heart Fail"},{"key":"2026012114184706000_ehf213739-bib-0003","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1016\/j.amjmed.2014.06.009","article-title":"Hemoconcentration-guided diuresis in heart failure","volume":"127","author":"Vaduganathan","year":"2014","journal-title":"Am J Med"},{"key":"2026012114184706000_ehf213739-bib-0004","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1161\/CIRCULATIONAHA.109.933275","article-title":"Potential effects of aggressive decongestion during the treatment of decompensated heart failure on renal function and survival","volume":"122","author":"Testani","year":"2010","journal-title":"Circulation"},{"key":"2026012114184706000_ehf213739-bib-0005","doi-asserted-by":"crossref","first-page":"1018","DOI":"10.1016\/j.cardfail.2011.08.004","article-title":"Clinical correlates of hemoconcentration during hospitalization for acute decompensated heart failure","volume":"17","author":"Davila","year":"2011","journal-title":"J Card Fail"},{"key":"2026012114184706000_ehf213739-bib-0006","doi-asserted-by":"crossref","first-page":"1973","DOI":"10.1016\/j.jacc.2012.12.050","article-title":"The predictive value of short-term changes in hemoglobin concentration in patients presenting with acute decompensated heart failure","volume":"61","author":"van der Meer","year":"2013","journal-title":"J Am Coll Cardiol"},{"key":"2026012114184706000_ehf213739-bib-0007","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1093\/eurjhf\/hft110","article-title":"Haemoconcentration, renal function, and post-discharge outcomes among patients hospitalized for heart failure with reduced ejection fraction: insights from the EVEREST trial","volume":"15","author":"Greene","year":"2013","journal-title":"Eur J Heart Fail"},{"key":"2026012114184706000_ehf213739-bib-0008","doi-asserted-by":"crossref","first-page":"4739","DOI":"10.1016\/j.ijcard.2013.07.241","article-title":"Hemoconcentration is a good prognostic predictor for clinical outcomes in acute heart failure: data from the Korean Heart Failure (KorHF) registry","volume":"168","author":"Oh","year":"2013","journal-title":"Int J Cardiol"},{"key":"2026012114184706000_ehf213739-bib-0009","volume-title":"Plasmapheresis","author":"Hakim","year":"2001"},{"key":"2026012114184706000_ehf213739-bib-0010","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1002\/ejhf.193","article-title":"Calculated plasma volume status and prognosis in chronic heart failure","volume":"17","author":"Ling","year":"2015","journal-title":"Eur J Heart Fail"},{"key":"2026012114184706000_ehf213739-bib-0011","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1016\/j.cardfail.2018.07.462","article-title":"Calculated estimates of plasma volume in patients with chronic heart failure-comparison with measured volumes","volume":"24","author":"Fudim","year":"2018","journal-title":"J Card Fail"},{"key":"2026012114184706000_ehf213739-bib-0012","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1172\/JCI102501","article-title":"Water diuresis produced during recumbency by the intravenous infusion of isotonic saline solution","volume":"30","author":"Strauss","year":"1951","journal-title":"J Clin Invest"},{"key":"2026012114184706000_ehf213739-bib-0013","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1016\/j.jchf.2015.06.014","article-title":"Prognostic value of estimated plasma volume in heart failure","volume":"3","author":"Duarte","year":"2015","journal-title":"JACC Heart Fail"},{"key":"2026012114184706000_ehf213739-bib-0014","doi-asserted-by":"crossref","first-page":"1392","DOI":"10.1007\/s00392-020-01639-4","article-title":"Prognostic impact of plasma volume estimated from hemoglobin and hematocrit in heart failure with preserved ejection fraction","volume":"109","author":"Kobayashi","year":"2020","journal-title":"Clin Res Cardiol"},{"key":"2026012114184706000_ehf213739-bib-0015","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1177\/0141076816661316","article-title":"Change in plasma volume and prognosis in acute decompensated heart failure: an observational cohort study","volume":"109","author":"Hudson","year":"2016","journal-title":"J R Soc Med"},{"key":"2026012114184706000_ehf213739-bib-0016","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1152\/jappl.1979.47.5.1031","article-title":"Plasma volume during stress in man: osmolality and red cell volume","volume":"47","author":"Greenleaf","year":"1979","journal-title":"J Appl Physiol"},{"key":"2026012114184706000_ehf213739-bib-0017","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.117.006817","article-title":"Role of volume redistribution in the congestion of heart failure","volume":"6","author":"Fudim","year":"2017","journal-title":"J Am Heart Assoc"},{"key":"2026012114184706000_ehf213739-bib-0018","doi-asserted-by":"crossref","first-page":"3070","DOI":"10.1002\/ehf2.13404","article-title":"Serum creatinine and cystatin C-based estimates of glomerular filtration rate are misleading in acute heart failure","volume":"8","author":"Swolinsky","year":"2021","journal-title":"ESC Heart Fail"},{"key":"2026012114184706000_ehf213739-bib-0019","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1056\/NEJMoa1005419","article-title":"Diuretic strategies in patients with acute decompensated heart failure","volume":"364","author":"Felker","year":"2011","journal-title":"N Engl J Med"},{"key":"2026012114184706000_ehf213739-bib-0020","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1159\/000496480","article-title":"A novel fluorescent clinical method to rapidly quantify plasma volume","volume":"9","author":"Molitoris","year":"2019","journal-title":"Cardiorenal Med"},{"key":"2026012114184706000_ehf213739-bib-0021","doi-asserted-by":"crossref","first-page":"1609","DOI":"10.1681\/ASN.2018020160","article-title":"A novel method for rapid bedside measurement of GFR","volume":"29","author":"Rizk","year":"2018","journal-title":"J Am Soc Nephrol"},{"key":"2026012114184706000_ehf213739-bib-0022","first-page":"17","article-title":"The significance of the total-body hematocrit in measurements of blood compartments","volume":"12","author":"Kirsch","year":"1971","journal-title":"J Nucl Med"},{"key":"2026012114184706000_ehf213739-bib-0023","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1016\/j.jchf.2014.02.007","article-title":"Understanding the heterogeneity in volume overload and fluid distribution in decompensated heart failure is key to optimal volume management: role for blood volume quantitation","volume":"2","author":"Miller","year":"2014","journal-title":"JACC Heart Fail"},{"key":"2026012114184706000_ehf213739-bib-0024","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1152\/jappl.1974.37.2.247","article-title":"Calculation of percentage changes in volumes of blood, plasma, and red cells in dehydration","volume":"37","author":"Dill","year":"1974","journal-title":"J Appl Physiol"},{"key":"2026012114184706000_ehf213739-bib-0025","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1152\/jappl.1974.37.6.912","article-title":"Alterations in red cell volume following exercise and dehydration","volume":"37","author":"Costill","year":"1974","journal-title":"J Appl Physiol"},{"key":"2026012114184706000_ehf213739-bib-0026","author":"Silver"},{"key":"2026012114184706000_ehf213739-bib-0027","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1161\/01.RES.5.3.257","article-title":"Effect of acute cardiac tamponade on red cell volume, total plasma protein and plasma volume","volume":"5","author":"Underwood","year":"1957","journal-title":"Circ Res"},{"key":"2026012114184706000_ehf213739-bib-0028","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1161\/01.CIR.18.4.581","article-title":"The splanchnic blood volume in congestive heart failure","volume":"18","author":"Rapaport","year":"1958","journal-title":"Circulation"},{"key":"2026012114184706000_ehf213739-bib-0029","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1007\/s00109-010-0710-6","article-title":"Heart failure-associated anemia: bone marrow dysfunction and response to erythropoietin","volume":"89","author":"Ruifrok","year":"2011","journal-title":"J Mol Med (Berl)"},{"key":"2026012114184706000_ehf213739-bib-0030","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1001\/archinte.1916.00080130010002","article-title":"A Formula to Estimate the Approximate Surface Area if Height and Weight Be Known","volume":"17","author":"Du Bois","year":"1916","journal-title":"Archives of Internal Medicine"}],"container-title":["ESC Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ehf2.13739","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ehf2.13739","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/9\/1\/66\/65375158\/eschf_9_1_66.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/9\/1\/66\/65375158\/eschf_9_1_66.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T19:22:17Z","timestamp":1769023337000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eschf\/article\/9\/1\/66\/8326386"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,8]]},"references-count":30,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,12,8]]},"published-print":{"date-parts":[[2022,2,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ehf2.13739","relation":{},"ISSN":["2055-5822"],"issn-type":[{"value":"2055-5822","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,2]]},"published":{"date-parts":[[2021,12,8]]},"assertion":[{"value":"2021-07-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-12-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}