Endothelium-derived relaxing factor is important in mediating the high output state in chronic severe anemia

Abstract

These findings support the hypothesis that enhanced basal endothelium-derived relaxing factor activity makes an important contribution to the low systemic vascular resistance in chronic severe anemia.

Sickle cell anemia is associated with reduced nitric oxide bioactivity in peripheral conduit and resistance vessels

“…Hemodynamic consequences of anemia including increased cardiac output and blood flow stimulate NO production and reduce peripheral vascular resistance [13]. In HbSS, additional effects of increased shear stress and tissue hypoxemia may further stimulate NOS expression and NO production.…”

“…One might consider the possibility that anemia itself may cause the observed abnormalities. However, anemia due to other causes, including aplastic anemia and iron deficiency, is not associated with an impairment of endothelium-derived NO, as the response to methacholine is preserved, with a comparable reduction in peak flow with L-NMMA [13]. Evidence of enhanced non-NO-dependent responses to methacholine has been reported in patients with congestive heart failure [14].…”

Circulating vascular endothelial growth factor and nitric oxide in patients with liver cirrhosis: A possible association with liver function impairment

“…NO participate in systemic hyperdynamic circulatory may be due to stimulation of constitutive NO synthase in patients with cirrhosis (30). Also, anemia, which is a frequent complication in liver cirrhosis, may therefore be a factor in enhanced activity of NO as haemoglobin is a potent inhibitor of NO (31).…”

Approaches to the treatment of anaemia in patients with chronic heart failure

“…Indeed, the fundamental problem (reduced oxygen delivery), the pathophysiologic responses and the symptoms and signs of anaemia closely (but not exactly) mirror those in chronic heart failure (CHF) [1][2][3]. Some differences exist; for example, anaemia is associated with vasodilatation whereas CHF is characterised by vasoconstriction [1][2][3].…”

“…Anaemia results in reduced oxygen delivery to the metabolising tissues, sets in train an array of neurohumoral, cardiovascular and renal responses and causes dyspnea, fatigue and oedema [1][2][3]. Indeed, the fundamental problem (reduced oxygen delivery), the pathophysiologic responses and the symptoms and signs of anaemia closely (but not exactly) mirror those in chronic heart failure (CHF) [1][2][3].…”