Aims Chronic heart failure (CHF) is frequently associated with a decreased haemoglobin level, whereas the mechanism remains largely unknown. Methods and results One hundred consecutive CHF patients without anaemia or renal dysfunction based on non-cardiac reasons were enrolled. We explored determinants of anaemia (as iron parameters, erythropoietin, hepcidin and kidney function) including red cell volume (RCV) (by a 51 Cr assay) as well as related markers and plasma volume. The influence of each factor on haemoglobin concentrations was determined in a multiple regression model. Mean haemoglobin concentrations were 11.7 +/- 0.8 mg/dL in anaemic CHF patients and 14.4 +/- 1.2 mg/dL in non-anaemic patients. Corrected reticulocytes were lower in anaemic patients (35.1 +/- 15.7 vs. 50.3 +/- 19.2 G/L, P = 0.001), but the RCV was not reduced (1659.3 +/- 517.6 vs. 1826.4 +/- 641.3 mL, P = 0.194). We found that plasma volumes were significantly higher in anaemic CHF patients (70.0 +/- 2.4 vs. 65.0 +/- 4.0%, P < 0.001). Plasma volume was the best predictor of haemoglobin concentrations in the regression model applied (B = -0.651, P < 0.001, R(2) = 0.769). Conclusion Haemodilution appears to be the most potent factor for the development of low haemoglobin levels in patients with CHF. Our data support an additional independent, but minor influence of iron deficiency on haemoglobin concentrations in CHF patients.

We demonstrate that Se administration in our AIT patient's cohort does not induce significant immunological changes, either in terms of cytokine production patterns of peripheral T lymphocytes or of TPOAb levels. Our data suggest that AIT patients with moderate disease activity (in terms of TPOAb and cytokine production patterns) may not (equally) benefit as patients with high disease activity.

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We investigated whether microRNA-21 and microRNA-148a are predictive for neoadjuvant treatment in esophageal adenocarcinoma. Thirty-six patients with neoadjuvant therapy and surgical resection were included. FFPE tissue from biopsy and esophagectomy were analyzed using RT-qPCR. Results were correlated to histological tumor regression, histopathological variables, FDG-PET-CT and survival. MicroRNA-21 was significantly higher in esophagectomies than in corresponding biopsies (p = .027). No association of microRNA-21 or microRNA-148a expression in tissue specimens with other clinical parameters was present. Although no influence of microRNA-21 and microRNA-148a on the response to neoadjuvant therapy was seen, upregulation of microRNA-21 might represent an escape mechanism of tumor cells.

Chronic heart failure (CHF) is frequently associated with a decreased hemoglobin level. Although in some patients renal anemia may develop, the mechanisms underlying the decrease in hemoglobin in isolated CHF remain largely unknown. We explored robust determinants of anemia including red cell mass as well as related markers and the plasma volume in patients with CHF without renal dysfunction based on non-cardiac reasons. One-hundred consecutive CHF patients were enrolled. The total red cell volume (RCV) was determined by a 51Cr assay. Furthermore, serum ferritin, erythropoietin, hepcidin, and renal function parameters were assessed. The influence of each factor on hemoglobin concentrations was determined in a multiple regression model. Mean hemoglobin concentrations were 11.7 ± 0.8mg/dL in anemic CHF patients and 14.4 ± 1.2mg/dL in non-anemic patients (p < 0.001). However, the RCV was not reduced (1659.3 ± 517.6mL versus 1826.4 ± 641.3mL, p = 0.194). There was no severe deficiency of iron or erythropoietin detectable in CHF patients but corrected reticulocytes were lower in anemic patients (35.1 ± 15.7G/L versus 50.3 ± 19.2G/L, p = 0.001). We found that plasma volume levels were significantly higher in anemic CHF patients, suggesting the presence of pseudoanemia (70.0 ± 2.4% versus 65.0 ± 4.0%, p < 0.001). Correspondingly, plasma volume was the best predictor of hemoglobin concentrations in the regression model applied (B = − 0.651, p < 0.001, R 2 = 0.769). Hemodilution appears to be the most potent factor for the development of low hemoglobin levels in patients with a broad spectrum of severity of heart failure. Our data support an additional independent, but minor influence of iron deficiency on lower than normal hemoglobin concentrations in CHF patients. The study results support not administering erythropoiesis stimulating agents to unselected CHF patients with lower than normal hemoglobin levels.