Blunted erythropoietin production and defective iron supply for erythropoiesis as major causes of anaemia in patients with chronic heart failure.

Abstract

AIMS:

Anaemia is often observed in patients with chronic heart failure (CHF), and it may be associated with a worse prognosis. Aim of this study was to identify the individual mechanisms of anaemia in CHF patients.

METHODS AND RESULTS:

One hundred and forty-eight consecutive patients with haemoglobin concentration <13 g/dL (if males) or <12 g/dL (if females) were enrolled. Factors responsible for anaemia were investigated by evaluating endogenous erythropoietin (Epo) production, serum cytokines levels, body iron status, and iron supply for erythropoiesis. Most patients (57%) presented anaemia of chronic disease and among them, 92% showed evidence of a defective endogenous Epo production. This was indicated by an observed/predicted log(serum Epo) ratio less than 0.8 and/or a defective iron supply for erythropoiesis diagnosed by low transferrin saturation and/or increased value of soluble transferrin receptor. According to regression analysis sex, renal failure, and serum Epo were correlated with anaemia.

CONCLUSION:

According to our study, about half of anaemic CHF patients showed anaemia of chronic disease with blunted endogenous Epo production and/or a defective iron supply for erythropoiesis. Determination of the individual mechanisms of anaemia in CHF could justify a rational therapeutic approach to anaemia.

• Authors: Cristina Opasich, Mario Cazzola, Laura Scelsi, Stefania De Feo, Enzo Bosimini, Rocco Lagioia, Oreste Febo, Roberto Ferrari, Alessandro Fucili, Remigio Moratti, Roberto Tramarin, Luigi Tavazzi
• Journal: European heart journal (Eur Heart J) Vol. 26 Issue 21 Pg. 2232-7 (Nov 2005) ISSN: 0195-668X [Print] England
• PMID: 15987710 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Cytokines
• Receptors, Transferrin
• Erythropoietin

Topics

• Anemia (etiology)
• Chronic Disease
• Cytokines (metabolism)
• Erythropoiesis (physiology)
• Erythropoietin (deficiency)
• Female
• Heart Failure (blood, complications)
• Humans
• Iron Deficiencies
• Male
• Middle Aged
• Receptors, Transferrin (metabolism)