Blunted erythropoietin production and defective iron supply for erythropoiesis as major causes of anaemia in patients with chronic heart failure. |
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Authors: | Cristina Opasich Mario Cazzola Laura Scelsi Stefania De Feo Enzo Bosimini Rocco Lagioia Oreste Febo Roberto Ferrari Alessandro Fucili Remigio Moratti Roberto Tramarin Luigi Tavazzi |
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Affiliation: | Department of Cardiology, Institute of Pavia, IRCCS Fondazione Salvatore Maugeri, Strada Ferrata 8, 27100 Pavia, Italy. copasich@fsm.it |
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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. |
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Keywords: | Chronic heart failure Anaemia Cytokines |
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