The use of subcutaneous erythropoietin and intravenous iron for the treatment of the anemia of severe, resistant congestive heart failure improves cardiac and renal function and functional cardiac class, and markedly reduces hospitalizations

Silverberg, Donald S.; Wexler, Dov; Blum, Miriam; Keren, Gad; Sheps, David S.; Leibovitch, Eyal; Brosh, David; Laniado, Shlomo; Schwartz, Doron; Yachnin, Tatyana; Shapira, Itzhak; Gavish, Dov; Baruch, Ron; Koifman, Bella; Kaplan, Carl P; Steinbruch, Shoshana; Iaina, Adrian

doi:10.1016/s0735-1097(00)00613-6

Cited by 648 publications

(576 citation statements)

References 54 publications

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“…We found that anemic patients were more physically and mentally fatigued than non-anemic patients and that decreased hemoglobin level predicted the sensation of general fatigue. Because anemia is common in patients with CHF, it is important to recognize the hemoglobin concentration in fatigued patients and, if possible, correct decreased levels in order to reduce fatigue and improve functional status and HRQOL (Silverberg et al, 2000).…”

Section: Discussionmentioning

confidence: 99%

Fatigue is a Prevalent and Severe Symptom Associated with Uncertainty and Sense of Coherence in Patients with Chronic Heart Failure

Falk

Swedberg

Gaston‐Johansson

et al. 2007

European Journal of Cardiovascular Nursing

100

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Although fatigue is a prevalent and distressing symptom in patients with chronic heart failure (CHF), it is an underestimated problem in the care of patients, and consequently, insuffi ciently investigated. The primary aim of this thesis was, therefore, to advance the knowledge from the patients' perspective by describing characteristics of the fatigue experience and its consequences in daily life in patients with CHF. A secondary aim was to investigate the relationships between fatigue and selected physiological and psychological factors associated with fatigue. Both quantitative and qualitative methods have been used and three samples of patients have been interviewed on different occasions. In two of the quantitative studies 93 patients, and in another study 112 patients, consecutively included, were interviewed at the hospital. Fifteen patients were included in the qualitative study. These 15 participants were enrolled when they visited an outpatient clinic and most of them were interviewed in their homes. These interviews were supplemented with the content of an Internet discussion with persons living with CHF.The results of the studies indicated that fatigue embraces the individual's body, emotions and cognitive abilities, forcing the person to physical restrictions that, in turn, perpetuate emotional discomfort. However, the physical sensation of fatigue followed by functional limitations seemed to be the most prevalent and distressing experience in patients with CHF. The patients described fatigue as lacking strength, which was associated in connection with physical efforts and lacking energy, viewed as an annoying sensation after both mental and physical strain. Another dimension of fatigue was described as being sleepy, often with a rapid and unforeseen onset. Consequences of fatigue, such as refraining from daily chores, denying oneself opportunities for rejoice and social isolation, further exaggerated the experience of fatigue. Restorative activities that engaged, absorbed or distracted the patients counteracted these negative consequences. Depressed mood was related to those fatigue dimensions that compromised functional ability and motivation to start any activities, whereas anxiety was associated with cognitive impairment. Feelings of uncertainty were related to physical tiredness, possibly infl icted by limitations in performing activities. Symptom distress that was caused by a number of reported symptoms other than fatigue had a diminutive infl uence on fatigue and separate symptoms that were associated with fatigue were, with the exception of breathlessness, not the fi rst and most pressing symptom reported by the patients. Anemic patients reported more fatigue compared with non-anemic patients and functional status, according to the New York Heart Association (NYHA) functional classifi cation criteria, was associated with those fatigue dimensions that encompassed physical tiredness and reduced functioning.The fi ndings provide new insights on the characteristics of fatigue and its con...

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Section: Discussionmentioning

confidence: 99%

Fatigue is a Prevalent and Severe Symptom Associated with Uncertainty and Sense of Coherence in Patients with Chronic Heart Failure

Falk

Swedberg

Gaston‐Johansson

et al. 2007

European Journal of Cardiovascular Nursing

100

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“…Among older adults, anemia has been associated with a wide spectrum of adverse outcomes (Lipschitz, 2003), including reduced quality of life (Thomas, 1998;Valderrabano, 2000), decreased muscle strength , increased disability , higher risk of Alzheimer's disease (Beard et al, 1997) and increased all-cause mortality among nursing home residents (Kikuchi et al, 2001), and among moderately to severely disabled women living in the community (Chaves et al, 2004). Anemia has also been linked with congestive heart failure (Silverberg et al, 2000) and impaired cognitive function (Nissenson, 1992). The reduction of oxygencarrying capacity of the blood that occurs with anemia may account for fatigue, cardiovascular complications and impaired physical performance (Lipschitz, 2003).…”

Section: Introductionmentioning

confidence: 99%

Low serum selenium is associated with anemia among older adults in the United States

Ferrucci

et al. 2007

Eur J Clin Nutr

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Objective: We hypothesized that low serum selenium was associated with anemia in humans. Subjects: A total of 2092 adults aged 65 and older, in the third National Nutrition Examination Survey, Phase 2 (1991-1994) (NHANES III). Methods: Examination of the relationship between serum selenium and hematological indices in NHANES III. Results: Anemia, defined by World Health Organization criteria, was present in 12.9%. Mean serum selenium among non-anemic and anemic adults was 1.60 and 1.51 mmol l À1 (P ¼ 0.0003). The prevalence of anemia among adults in the lowest to highest quartiles of serum selenium was 18.3, 9.5, 9.7 and 6.9%, respectively (P ¼ 0.0005). The proportion of adults in the lowest quartile of selenium among those who were non-anemic or who had anemia due to nutritional causes, chronic inflammation, renal disease or unexplained anemia was 9.9, 27.5, 17.5, 24.0 and 15.4%, respectively. An increase in log e selenium was associated with a reduced risk of anemia (odds ratio per one standard deviation increase 0.75, 95% confidence interval 0.58-0.97, P ¼ 0.03), adjusting for age, race, education, body mass index and chronic diseases. Conclusion: Low serum selenium is independently associated with anemia among older men and women in the United States.

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“…1 In 142 cases of CHF seen in a cardiac outpatient clinic devoted to CHF, 55.6% were found to have anemia as defined as a hemoglobin (Hb) concentration of < 12 g/dL. The more severe the CHF, the more prevalent and severe was the anemia.…”

Section: Initial Observations On Anemia and Chfmentioning

confidence: 99%

“…As mentioned initially, when we corrected the anemia in 26 severe CHF patients, the CHF improved dramatically. 1 In a subsequent randomized controlled (but not double-blind) study, 86 32 such resistant anemic CHF patients were assigned to 2 groups: 16 received the EPO/IV iron combination and the other 16 did not. In the 16 who were treated, the anemia improved and the NYHA and LVEF improved significantly, the serum creatinine did not change, and the rate of hospitalization fell significantly, as did the doses of oral and IV furosemide.…”

mentioning

confidence: 99%

The Role of Anemia in the Progression of Congestive Heart Failure: Is There a Place for Erythropoietin and Intravenous Iron?

Silverberg

Wexler

Iaina

et al. 2008

Transfusion Alternatives in Transfusion Medicine

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The use of subcutaneous erythropoietin and intravenous iron for the treatment of the anemia of severe, resistant congestive heart failure improves cardiac and renal function and functional cardiac class, and markedly reduces hospitalizations

Abstract: Anemia is very common in CHF and its successful treatment is associated with a significant improvement in cardiac function, functional class, renal function and in a marked fall in the need for diuretics and hospitalization.

Cited by 648 publications

References 54 publications

Fatigue is a Prevalent and Severe Symptom Associated with Uncertainty and Sense of Coherence in Patients with Chronic Heart Failure

Fatigue is a Prevalent and Severe Symptom Associated with Uncertainty and Sense of Coherence in Patients with Chronic Heart Failure

Low serum selenium is associated with anemia among older adults in the United States

The Role of Anemia in the Progression of Congestive Heart Failure: Is There a Place for Erythropoietin and Intravenous Iron?

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