Clinical Research in Cardiology

, Volume 108, Issue 5, pp 563–573 | Cite as

Diagnostic and prognostic value of plasma volume status at emergency department admission in dyspneic patients: results from the PARADISE cohort

  • Tahar Chouihed
  • Patrick Rossignol
  • Adrien Bassand
  • Kévin Duarte
  • Masatake Kobayashi
  • Déborah Jaeger
  • Sonia Sadoune
  • Aurélien Buessler
  • Lionel Nace
  • Gaetan Giacomin
  • Thibaut Hutter
  • Françoise Barbé
  • Sylvain Salignac
  • Nicolas Jay
  • Faiez Zannad
  • Nicolas GirerdEmail author
Original Paper



Systemic congestion, evaluated by estimated plasma volume status (ePVS), is associated with in-hospital mortality in acute heart failure (AHF). However, the diagnostic and prognostic value of ePVS in patients with acute dyspnea has been insufficiently studied.


To assess the association between the first ePVS calculated from blood samples on admission in the emergency department (ED) and discharge diagnosis of AHF and in-hospital mortality in patients admitted for acute dyspnea.


The study included 1369 patients admitted for dyspnea in the ED in 2015. ePVS was calculated from hematocrit and hemoglobin values at admission. Comparisons of baseline characteristics according to ePVS tertiles were carried out and then associations between ePVS and the two outcomes “AHF diagnosis” and “intra-hospital mortality” were assessed using a logistic regression model.


36.6% had a BNP > 400 pg/mL and median ePVS was 4.58 dL/g [3.96–5.55]. Overall in-hospital mortality was 11.1% (n = 149). In multivariable analysis, the third ePVS tertile (> 5.12 dL/g) had a significantly increased risk of having AHF (OR = 1.64 [1.16–2.33], p = 0.005). In-hospital mortality rose across ePVS tertiles (8.4–13.8% p < 0.01). ePVS greater than the first or second tertile threshold (respectively, 4.17 dL/g and 5.12 dL/g) were both significantly associated with a higher risk of in-hospital mortality (OR for 2nd/3rd tertile = 2.06 [1.25–3.38], p = 0.004 and OR for 3rd tertile = 1.54 [1.01–2.36], p = 0.04).


Higher ePVS values determined from first blood sample at admission are associated with a higher probability of AHF and in-hospital mortality in patients admitted in the ED for acute dyspnea.


Congestion Estimated plasma volume status Acute dyspnea Emergency Acute heart failure Mortality 



Acute heart failure


Brain natriuretic peptide


Confidence interval


Emergency department


Estimated glomerular filtration rate


Estimated plasma volume status


Heart failure






Odds ratios



We thank Pierre Pothier for editing the manuscript. TC, KD, PR, FZ and NG are supported by the French National Research Agency Fighting Heart Failure (ANR-15-RHU-0004) and GEENAGE Lorraine Université d’Excellence programs and by Contrat de Plan État Région Lorraine and FEDER IT2MP. We also thank Frederic Arnoux for biological data extraction.

Compliance with ethical standards

Conflict of interest

Dr Chouihed and Dr. Girerd have received board membership fees from Novartis. Dr. Rossignol received fees from Relypsa. Dr. Zannad has received fees for serving on the board of Boston Scientific; consulting fees from Novartis, Takeda, AstraZeneca, Boehringer Ingelheim, GE Healthcare, Relypsa, Servier, Boston Scientific, Bayer, Johnson and Johnson, and Resmed; and speakers’ fees from Pfizer and AstraZeneca. He and Dr. Rossignol are cofounders of CardioRenal diagnosticS.

Supplementary material

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Supplementary material 5 (DOCX 17 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Tahar Chouihed
    • 1
    • 2
    • 3
    • 5
  • Patrick Rossignol
    • 2
    • 3
    • 5
  • Adrien Bassand
    • 1
    • 2
    • 3
  • Kévin Duarte
    • 2
    • 3
    • 6
    • 7
    • 8
  • Masatake Kobayashi
    • 2
    • 3
    • 4
  • Déborah Jaeger
    • 1
    • 2
    • 3
  • Sonia Sadoune
    • 1
  • Aurélien Buessler
    • 1
  • Lionel Nace
    • 9
  • Gaetan Giacomin
    • 1
  • Thibaut Hutter
    • 1
  • Françoise Barbé
    • 10
  • Sylvain Salignac
    • 11
  • Nicolas Jay
    • 12
    • 13
  • Faiez Zannad
    • 2
    • 3
    • 5
    • 14
  • Nicolas Girerd
    • 2
    • 3
    • 5
    • 14
    Email author
  1. 1.Emergency DepartmentUniversity Hospital of NancyVandoeuvre les NancyFrance
  2. 2.INSERM, Centre d’Investigations Cliniques Plurithématique 1433Institut Lorrain du Coeur et des VaisseauxVandoeuvre les NancyFrance
  3. 3.Groupe choc, Faculté de MédecineINSERM U1116Vandoeuvre les NancyFrance
  4. 4.Department of CardiologyTokyo Medical UniversityTokyoJapan
  5. 5.F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists)NancyFrance
  6. 6.Université de Lorraine, Institut Elie Cartan de Lorraine, Unité Mixte de Recherche 7502Vandoeuvre-lès-NancyFrance
  7. 7.Centre National de la Recherche Scientifique, Institut Elie Cartan de Lorraine, Unité Mixte de Recherche 7502Vandoeuvre-lès-NancyFrance
  8. 8.INRIA, Project-Team BIGSVillers-lès-NancyFrance
  9. 9.Réanimation MédicaleHôpital Central, CHRU NancyVandoeuvre les NancyFrance
  10. 10.Biochimie, Biologie moléculaire, Nutrition, Métabolisme, Hôpital de BraboisCHRU NancyNancyFrance
  11. 11.Hématologie, Hôpital de Brabois, CHRU NancyVandoeuvre les NancyFrance
  12. 12.Department of Medical InformaticsUniversity HospitalVandoeuvre les NancyFrance
  13. 13.Orpailleur, LORIA UMR 7503Vandoeuvre les NancyFrance
  14. 14.Pôle de Cardiologie, Institut Lorrain du Coeur et des VaisseauxCHRU NancyVandoeuvre les NancyFrance

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