HEMODYNAMIC-CHANGES INDUCED BY EPO TREATMENT AFTER ONE YEAR

We have studied 39 patients with Doppler-M mode echocardiography, before starting treatment with erythropoietin, after reaching the target hemoglobin, and after one year of treatment. We evaluated the following echocardiographic parameters: Lek ventricular diameters, lef ventricular weight, fractional shortening and ejection fraction as well as cardiac output index and peripheral vascular resistance index normalized to valvular area. We analized the incidence of hypertension and the relation between hemoglobine levels and ecocardiographics parameters. 35,8 % of the patients developed arterial hypertension during the initial phases of treatment. Neither the basal Hb or target Hb were different in this group. Wen target hemoglobine was reached, cardiac output was less and peripheral resistances were higher in patients with Hb > 10,5 g/dl than in those with lower figures. The differences dissappeared after one year of treatment. During this period the ventricular function got better only in the patients with higher levels of hemoglobine. This behaviour suggest that it is convenient as effective correction of the anemia to improve the ventricular function on the long term. Nevertheless, we think that during the initial phases of treatment the correction must be done slowly to avoid as much as possible the initial hemodinamic effects.