Effect of Anemia on Cardiovascular Hemodynamics, Therapeutic Strategy and Clinical Outcomes in Patients With Heart Failure and Hemodynamic Congestion

Abstract

Background:We investigated the effect of anemia on cardiovascular hemodynamics, therapeutic strategies and clinical outcomes in heart failure (HF) patients. Methods and Results:We divided 198 consecutive HF patients who underwent right heart catheterization before in-hospital HF treatment into 2 groups according to the presence or absence of hemodynamic congestion (HC: mean pulmonary capillary wedge pressure ≥15 mmHg and/or mean right atrial pressure ≥10 mmHg). The hemoglobin level correlated with the cardiac index (CI) and systemic vascular resistance index (SVRI) (r=−0.34 and 0.42, P<0.05, respectively), and was the strongest contributor of SVRI only in the HC group. Anemic patients more frequently required intravenous inotropic support despite having higher CI and lower SVRI than non-anemic patients in the HC group. The novel hemodynamic subsets based on mean right atrial pressure and estimated left ventricular stroke work index but not Forrester subsets appropriately predicted the need for intravenous inotropic support. The probability of hospitalization for worsening HF during 2-year follow-up period was significantly higher in anemic patients than in nonanemic patients in the HC group.Conclusions: Anemia had a direct effect on cardiovascular hemodynamics and thus can confound therapeutic planning in HF patients with HC. The novel hemodynamic subsets can be applied in daily clinical practice regardless of the presence or absence of anemia.

Association of N-Terminal Pro B-Type Natriuretic Peptide With Blood Pressure and Pulse Pressure in Elderly People ― A Cross-Sectional Population Study ―

“…Third, anemia increases plasma volume, resulting in cardiac volume overload. 12, 32 In the present study, NT-proBNP was inversely associated with hemoglobin levels, and approximately 50% of participants with a hemoglobin in the range ≥10 to <12 g/dL had high NT-proBNP concentrations, suggesting that even mild anemia could contribute to increases in BNP concentrations. Taken together, these results indicate that these confounding factors should be considered when evaluating BNP concentrations in elderly people.…”

Night Sleep Duration and Risk of Incident Anemia in a Chinese Population: A Prospective Cohort Study

“…Similar with the common cardiovascular risk factors, such as smoking, diabetes, hypertension and hypercholesterolemia, anemia can also increase the risk of mortality, morbidity and hospitalization 1 – 6 . Consequently, anemia has lately been characterized as another cardiovascular risk factor 7 – 9 . Thus, it is necessary to identify anemia-related risk factors so that.…”

Sleeping Difficulty and Subjective Short Sleep Duration are Associated with Serum N-terminal Pro-brain Natriuretic Peptide Levels in the Elderly Population

“…The associations of the sleep quality (overall poor sleep, subjective poor sleep quality, sleeping difficulty, subjective short sleep duration, use of sleeping medications, and daytime dysfunction) with high NT-proBNP levels were assessed using a multivariate logistic regression analysis. The model included age, female sex (yes or no) ( 27 ), BMI, serum hemoglobin concentration ( 28 ), serum creatinine level ( 29 ), systolic BP, diastolic BP, and the use of antihypertensive medications (yes or no). All of these were variables with p values <0.05 in the univariate logistic regression analysis (Model 1).…”