Effect of Darbepoetin Alfa on Exercise Tolerance in Anemic Patients With Symptomatic Chronic Heart Failure

Ponikowski, Piotr; Anker, Stefan D.; Szachniewicz, Joanna; Okonko, Darlington O.; Ledwidge, Mark; Zymliński, Robert; Ryan, Enda; Wasserman, Scott M.; Baker, Nigel; Rosser, Dylan; Rosen, Stuart D.; Poole‐Wilson, Philip A.; Banasiak, Waldemar; Coats, Andrew J.S.; McDonald, Ken

doi:10.1016/j.jacc.2006.11.024

Cited by 199 publications

(146 citation statements)

References 28 publications

(35 reference statements)

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“…However, only four [21][22][23] reports all based on small studies, showed the effect of anemia correction on peak exercise _ VO 2 in HF patients, with discordant findings. Indeed, three reports showed that anemia treatment increased exercise performance [21,22,24] while one did not [23].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have focused on the effect of anemia correction, usually by iron and erythropoietin or darbopoietin, on exercise performance, measured either by peak _ VO 2 , exercise tolerance or by distance walked at the 6 min walking test, in both HF and non-HF patients [21][22][23][24][25][26][27][28][29]. However, only four [21][22][23] reports all based on small studies, showed the effect of anemia correction on peak exercise _ VO 2 in HF patients, with discordant findings. Indeed, three reports showed that anemia treatment increased exercise performance [21,22,24] while one did not [23].…”

Section: Discussionmentioning

confidence: 99%

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Relationship of resting hemoglobin concentration to peak oxygen uptake in heart failure patients

et al. 2010

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Anemia is frequent in chronic heart failure (HF). To calculate what change in peak oxygen uptake ( _ VO 2 ) should be expected in the event of changes in hemoglobin concentration, we studied the correlation between peak _ VO 2 and hemoglobin concentration in a large HF population. We carried out retrospective analysis of all cardiopulmonary exercise tests (CPET) performed in our HF Clinic between June 2001 and March 2009 in HF patients who had a resting hemoglobin concentration measurement taken within 7 days of the CPET. We collected 967 CPETs, 704 tests were considered maximal and analyzed. We identified 181 patients (26%) as anemic. Peak _ VO 2 was lower (P < 0.001) in anemic patients (971 ± 23 ml/min) compared with nonanemic (1243 ± 18 ml/min). The slope of the _ VO 2 vs. hemoglobin ratio was 109 ml/min/g/dl at peak exercise. This correlation remained significant also when several confounding variables were analyzed by multivariate analysis. As an average, each gram of hemoglobin accounts, at peak exercise, for 109 ml/min change in _ VO 2 which is equivalent to 0.97 ml/min/kg. Therefore, in HF patients anemia treatment should increase _ VO 2 by 109 ml/min for each g/dl of hemoglobin increase. Am. J. Hematol. 85:414-417, 2010. V

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Relationship of resting hemoglobin concentration to peak oxygen uptake in heart failure patients

et al. 2010

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“…Iron supplementation and treatment with erythropoiesis-stimulating agents (ESAs), or a combination of both, are potentially valuable therapeutic options [26,27].…”

Section: Cardio-renal Anemia Syndromementioning

confidence: 99%

Cardiac Mortality-Risk Assessment Improved by Evaluation of Hemoglobin Level in Combination with Kidney Function in the Patients with Systolic Heart Failure: A Cohort Study

Doi¹

2013

J Clin Exp Cardiolog

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“…A positive correlation has been shown between peak VO2 and serum Hb values [56,57]. The administration of erythropoiesis stimulating agents (ESA) has been related to an improvement in exercise capacity either in patients with renal failure [58] or in patients with HF [22,43,59].…”

Section: Oxygen Uptake In Peripheral Tissuesmentioning

confidence: 99%

Anaemia and heart failure

et al. 2010

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AbstractAnaemia is one of the most frequent co-morbidities in patients with heart failure. Its prevalence increases from 4% to7% in subjects with asymptomatic left ventricular dysfunction to >30% in patients with severe heart failure. Renal insufficiency, activation of inflammatory mediators and treatment with renin-angiotensin antagonists seem to be its main determinants. The results of many studies agree in providing evidence that anaemia is a powerful independent determinant of survival in patients with heart failure. However, the mechanisms of this relation are still not fully understood. Moreover a favourable effect of the correction of anaemia on prognosis has not yet been shown. Also In addition to this, controlled studies assessing its effects on exercise tolerance have yielded controversial results. Further research is needed to assess the effect of correcting anaemia in chronic heart failure (CHF) patients; ongoing reduction of events with RED-HF (Darbepoetin alpha in heart failure) trial will help define the role.

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Effect of Darbepoetin Alfa on Exercise Tolerance in Anemic Patients With Symptomatic Chronic Heart Failure

Cited by 199 publications

References 28 publications

Relationship of resting hemoglobin concentration to peak oxygen uptake in heart failure patients

Relationship of resting hemoglobin concentration to peak oxygen uptake in heart failure patients

Cardiac Mortality-Risk Assessment Improved by Evaluation of Hemoglobin Level in Combination with Kidney Function in the Patients with Systolic Heart Failure: A Cohort Study

Anaemia and heart failure

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