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Venous Tone and Stressed Blood Volume in Heart Failure: JACC Review Topic of the Week

Marat Fudim1, David M Kaye2, Barry A Borlaug3

  • 1Division of Cardiology, Department of Medicine, Duke University, Durham, North Carolina, USA; Duke Clinical Research Institute, Durham, North Carolina, USA.

Journal of the American College of Cardiology
|May 5, 2022
PubMed

Insights

Heart failure (HF) involves elevated cardiac filling pressures due to venous system changes. Understanding stressed and unstressed blood volume offers new insights into HF hemodynamics and treatments.

Area of Science:

  • Cardiovascular Physiology
  • Heart Failure Pathophysiology
  • Hemodynamics

Background:

  • Pathologic processes like myocardial dysfunction and volume overload elevate cardiac filling pressures in heart failure (HF).
  • The venous system plays a crucial role in regulating these pressures.
  • Key concepts include stressed blood volume and unstressed blood volume.

Purpose of the Study:

  • To review the role of the venous system in heart failure.
  • To explain the concepts of stressed and unstressed blood volume.
  • To discuss how venous tone affects blood distribution and HF hemodynamics.

Main Methods:

  • Review of existing literature on venous system function in HF.
  • Discussion of the regulation of venous tone and its impact on blood volume distribution.
  • Examination of methods for estimating stressed blood volume.

Main Results:

  • Regulation of venous tone significantly alters the distribution of blood between stressed and unstressed compartments.
  • This distribution impacts the balance of blood between pulmonary and systemic circulations.
  • Altered venous dynamics contribute to hemodynamic abnormalities in HF.

Conclusions:

  • Understanding stressed blood volume is critical for comprehending HF pathophysiology.
  • New methods for estimating stressed blood volume provide novel insights into HF hemodynamics.
  • These insights can inform therapeutic strategies for heart failure management.

Keywords:
exerciseheart failurestressed blood volumeunstressed blood volumevenous tonevolume regulation

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