Effects of β-erythropoietin treatment on left ventricular remodeling, systolic function, and B-type natriuretic peptide levels in patients with the cardiorenal anemia syndrome
Open Access
- 1 October 2007
- journal article
- research article
- Published by Elsevier BV in American Heart Journal
- Vol. 154 (4), 645.e9-645.e15
- https://doi.org/10.1016/j.ahj.2007.07.022
Abstract
Although anemia is frequently found in congestive heart failure (CHF), little is known about the effect of its correction with erythropoietin (EPO) on cardiac structure and function. The present study examines in patients with advanced CHF, chronic renal insufficiency, and anemia the effects of beta-EPO on left ventricular (LV) systolic diameter and volume (LVSD and LVSV), LV diastolic diameter and volume (LVDD and LVDV), LV mass, LV ejection fraction (LVEF), pulmonary artery pressure (PAP), and B-type natriuretic peptide (BNP) levels. Fifty-one consecutive subjects affected with advanced CHF and anemia were studied. We performed a randomized double-blind controlled study of correction of anemia with subcutaneous EPO for 4 months (group A, 26 patients) using saline as the placebo in the control group (group B, 25 patients). We then maintained the EPO treatment in the treated group for another 8 months. Both groups received oral iron throughout the total 12-month period. Echocardiographic evaluation, BNP levels, and hematological parameters are reported at 4 and 12 months. The patients in group A during the double-blind phase (4 months) demonstrated an increase in LVEF and mild reduction in LVSD and LVSV with respect to baseline and to group B with no differences in PAP, LVDD, and LVDV. Over the 12-month period, the hemoglobin increased from 10.40.6 to 12.4 +/- 0.8 g/dL (P < .01) in group A but did not change in group B. Compared with group B, group A had lower LVDD, LVSD, LVDV, LVSV, LV mass, PAP, and BNP and higher LVEF. The serum creatinine and creatinine clearance remained unchanged in the 2 groups. In anemic patients with CHF, correction of anemia with EPO and oral iron over 1 year lead to an improvement in LV systolic function, LV remodeling, BNP levels, and PAP compared with a control group in which only oral iron was used.Keywords
This publication has 29 references indexed in Scilit:
- Intravenous Iron Alone for the Treatment of Anemia in Patients With Chronic Heart FailureJournal of the American College of Cardiology, 2006
- The Interaction Between Heart Failure and Other Heart Diseases, Renal Failure, and AnemiaSeminars in Nephrology, 2006
- Clinical trials update from the European Society of Cardiology Heart Failure meeting and the American College of Cardiology: Darbepoetin alfa study, ECHOS, and ASCOT-BPLAEuropean Journal of Heart Failure, 2005
- Prevalence of anemia and effects on mortality in patients with heart failureAmerican Heart Journal, 2005
- Effects of Treatment with Epoetin Beta on Outcomes in Patients with Anaemia and Chronic Heart FailureKidney and Blood Pressure Research, 2004
- Anemia as a risk factor and therapeutic target in heart failureJournal of the American College of Cardiology, 2004
- The effect of correction of mild anemia in severe, resistant congestive heart failure using subcutaneous erythropoietin and intravenous iron: a randomized controlled studyJournal of the American College of Cardiology, 2001
- 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 hospitalizationsJournal of the American College of Cardiology, 2000
- Can physicians always explain the results of clinical trials? a case study of amlodipine in heart failureThe American Journal of Cardiology, 1999
- Epidemiology and prevention of cardiac failure: Framingham Study insightsEuropean Heart Journal, 1987