Blunted erythropoietin production and defective iron supply for erythropoiesis as major causes of anaemia in patients with chronic heart failure.

Abstract:

AIMS:Anaemia is often observed in patients with chronic heart failure (CHF), and it may be associated with a worse prognosis. Aim of this study was to identify the individual mechanisms of anaemia in CHF patients. METHODS AND RESULTS:One hundred and forty-eight consecutive patients with haemoglobin concentration <13 g/dL (if males) or <12 g/dL (if females) were enrolled. Factors responsible for anaemia were investigated by evaluating endogenous erythropoietin (Epo) production, serum cytokines levels, body iron status, and iron supply for erythropoiesis. Most patients (57%) presented anaemia of chronic disease and among them, 92% showed evidence of a defective endogenous Epo production. This was indicated by an observed/predicted log(serum Epo) ratio less than 0.8 and/or a defective iron supply for erythropoiesis diagnosed by low transferrin saturation and/or increased value of soluble transferrin receptor. According to regression analysis sex, renal failure, and serum Epo were correlated with anaemia. CONCLUSION:According to our study, about half of anaemic CHF patients showed anaemia of chronic disease with blunted endogenous Epo production and/or a defective iron supply for erythropoiesis. Determination of the individual mechanisms of anaemia in CHF could justify a rational therapeutic approach to anaemia.

journal_name

Eur Heart J

journal_title

European heart journal

authors

Opasich C,Cazzola M,Scelsi L,De Feo S,Bosimini E,Lagioia R,Febo O,Ferrari R,Fucili A,Moratti R,Tramarin R,Tavazzi L

doi

10.1093/eurheartj/ehi388

subject

Has Abstract

pub_date

2005-11-01 00:00:00

pages

2232-7

issue

21

eissn

0195-668X

issn

1522-9645

pii

ehi388

journal_volume

26

pub_type

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