Grodin JL, et al. - Among the enrollees from the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist Trial (TOPCAT) with available hematocrit and weight data (n = 3,414), researchers assessed if calculated plasma volume status (PVS) has any impact on outcomes in heart failure with preserved ejection fraction (HFpEF) using multivariable Cox proportional hazards models. The median PVS was –11.9% (25^th-75th percentile: –17.2% to –6.4%). PVS consistent with relative volume contraction (PVS ≤ 0%) as opposed to volume expansion (8.9%, PVS > 0%) was seen in most patients (91.1%). In association with each 5% increment in PVS, an approximately 11%, 14%, and 12% higher risk for the primary composite endpoint, all-cause death, and heart failure hospitalization, respectively, but not cardiovascular death, was noted, after multivariable adjustment. Overall, in HFpEF, an independent link was observed between higher calculated estimates of PVS and a higher risk of long-term clinical outcomes, especially heart failure hospitalization.