Anemia and Iron Deficiency in Heart Failure

Magrì, Damiano; Martino, Fabiana De; Moscucci, Federica; Agostoni, Piergiuseppe; Sciomer, Susanna

doi:10.1016/j.hfc.2019.02.005

Cited by 24 publications

(20 citation statements)

References 62 publications

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“…It is also worth mentioning that our results confirmed the previously reported strong correlation between anaemia and comorbidities of negative prognostic value [1][2][3]23]. Patients with decreased Hb had a higher prevalence atrial fibrillation and chronic kidney disease in medical history, as well as higher creatinine concentration and lower eGFR.…”

Section: Discussionsupporting

confidence: 90%

“…e anaemia-mediated high-output state initially supports an increase in oxygen transport, but in the long term, it contributes to the worsening of cardiovascular function, especially in HF patients [2,15].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Anaemia is a common comorbidity in patients with heart failure (HF) and is associated with increased symptom severity and higher mortality [1,2]. Even a small reduction in haemoglobin (Hb) concentration is associated with less favourable outcomes [2]. e following factors have been suggested to cause anaemia in HF patients: iron deficiency, neurohormonal and proinflammatory activation, renal dysfunction, reduced erythropoiesis, haemodilution, and some medications [2,3].…”

Section: Introductionmentioning

confidence: 99%

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Haemodynamic Effects of Anaemia in Patients with Acute Decompensated Heart Failure

Krzesiński

Galas

Gielerak

et al. 2020

Cardiology Research and Practice

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Anaemia is a common comorbidity in patients with heart failure (HF) and is associated with more severe symptoms and increased mortality. The aim of this study was to evaluate haemodynamic profiles of HF patients with respect to the presence of reduced left ventricular ejection fraction (LVEF) and anaemia. Methods and Results. Haemodynamic status was evaluated in 97 patients with acute decompensated HF. Impedance cardiography, echocardiography, and N-terminal probrain natriuretic peptide (NT-proBNP) results were analysed. The study group was stratified into four subgroups according to LVEF (<40% vs ≥40%) and the presence of anaemia (haemoglobin <13.0 g/dL in men and <12.0 g/dL in women). Thoracic fluid content was higher (p=0.037) in anaemic subjects, while no significant relation between anaemia and NYHA was observed. Anaemic subjects with LVEF ≥ 40% were distinguished from those with LVEF < 40% by significantly higher stroke index (p=0.002), Heather index (p=0.014), and acceleration index (p=0.047). Patients with reduced LVEF and anaemia presented the highest NT-proBNP (p=0.003). Conclusions. In acute decompensated HF, anaemia is related with fluid overload, relatively higher cardiac systolic performance but no clinical benefit in patients with preserved/midrange LVEF, and increased left ventricular tension, fluid overload, and impaired cardiac systolic performance in patients with reduced LVEF.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Haemodynamic Effects of Anaemia in Patients with Acute Decompensated Heart Failure

Krzesiński

Galas

Gielerak

et al. 2020

Cardiology Research and Practice

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“…Moreover, a progressive reduction of hemoglobin (Hb) implies a poor prognosis [5,6]. The origin of anemia in HF is multifactorial and includes fluid retention, chronic kidney disease, undernutrition, relatively low levels of erythropoietin, inflammation, and drugs blocking the renin-angiotensin system that reduce erythropoietin, erythroid progenitors, and the degradation of an inhibitor of erythropoiesis [3,7]. In addition, blood loss can contribute to significant reductions in Hb levels.…”

Section: Introductionmentioning

confidence: 99%

Impact of Acute Hemoglobin Falls in Heart Failure Patients: A Population Study

Lopez

Holgado

Fernández

et al. 2020

JCM

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Aims: This study assessed the impact of acute hemoglobin (Hb) falls in heart failure (HF) patients. Methods: HF patients with repeated Hb values over time were included. Falls in Hb greater than 30% were considered to represent an acute episode of anemia and the risk of hospitalization and all-cause mortality after the first episode was assessed. Results: In total, 45,437 HF patients (54.9% female, mean age 74.3 years) during a follow-up average of 2.9 years were analyzed. A total of 2892 (6.4%) patients had one episode of Hb falls, 139 (0.3%) had more than one episode, and 342 (0.8%) had concomitant acute kidney injury (AKI). Acute heart failure occurred in 4673 (10.3%) patients, representing 3.6/100 HF patients/year. The risk of hospitalization increased with one episode (Hazard Ratio = 1.30, 95% confidence interval (CI) 1.19–1.43), two or more episodes (HR = 1.59, 95% CI 1.14–2.23, and concurrent AKI (HR = 1.61, 95% CI 1.27–2.03). A total of 10,490 patients have died, representing 8.1/100 HF patients/year. The risk of mortality was HR = 2.20 (95% CI 2.06–2.35) for one episode, HR = 3.14 (95% CI 2.48–3.97) for two or more episodes, and HR = 3.20 (95% CI 2.73–3.75) with AKI. In the two or more episodes and AKI groups, Hb levels at the baseline were significantly lower (10.2–11.4 g/dL) than in the no episodes group (12.8 g/dL), and a higher and significant mortality in these subgroups was observed. Conclusions: Hb falls in heart failure patients identified those with a worse prognosis requiring a more careful evaluation and follow-up.

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Renal and Heart Failure Interrelationship in Hypertension

Redon

2023

Updates in Hypertension and Cardiovascular Protection

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Anemia and Iron Deficiency in Heart Failure

Cited by 24 publications

References 62 publications

Haemodynamic Effects of Anaemia in Patients with Acute Decompensated Heart Failure

Haemodynamic Effects of Anaemia in Patients with Acute Decompensated Heart Failure

Impact of Acute Hemoglobin Falls in Heart Failure Patients: A Population Study

Renal and Heart Failure Interrelationship in Hypertension

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