Heart failure and anemia: Effects on prognostic variables

被引：33

作者：

Cattadori, Gaia ^{[1
,2
]}

Agostoni, Piergiuseppe ^{[1
,3
]}

Corra, Ugo ^{[4
]}

Sinagra, Gianfranco ^{[5
]}

Veglia, Fabrizio ^{[1
]}

Salvioni, Elisabetta ^{[1
]}

Bonomi, Alice ^{[1
]}

La Gioia, Rocco ^{[6
]}

Scardovi, Angela B. ^{[7
]}

Ferraironi, Alessandro ^{[7
]}

Emdin, Michele ^{[8
,9
]}

Metra, Marco ^{[10
]}

Di Lenarda, Andrea ^{[11
]}

Limongelli, Giuseppe ^{[12
]}

Raimondo, Rosa ^{[13
]}

Re, Federica ^{[14
,15
,16
]}

Guazzi, Marco ^{[17
]}

Belardinelli, Romualdo ^{[18
]}

Parati, Gianfranco ^{[19
,20
]}

Caravita, Sergio ^{[19
,20
]}

Magri, Damiano ^{[21
]}

Lombardi, Carlo

Frigerio, Maria ^{[22
]}

Oliva, Fabrizio ^{[22
]}

Girola, Davide

Mezzani, Alessandro

Farina, Stefania ^{[1
]}

Mapelli, Massimo ^{[1
]}

Scrutinio, Domenico ^{[6
]}

Pacileo, Giuseppe ^{[12
]}

Apostolo, Anna ^{[1
]}

Iorio, AnnaMaria ^{[1
]}

Paolillo, Stefania ^{[23
]}

Filardi, Pasquale Perrone ^{[24
]}

Gargiulo, Paola ^{[23
]}

Bussotti, Maurizio ^{[25
]}

Marchese, Giovanni ^{[25
]}

Correale, Michele ^{[26
]}

Badagliacca, Roberto ^{[27
]}

Sciomer, Susanna ^{[27
]}

Palermo, Pietro ^{[1
]}

Contini, Mauro ^{[1
]}

Giannuzzi, Pantaleo ^{[4
]}

Battaia, Elisa ^{[28
]}

Cicoira, Mariantonietta ^{[28
]}

Clemenza, Francesco ^{[29
]}

Mina, Chiara ^{[29
]}

Binno, Simone ^{[30
]}

Passino, Claudio

Piepoli, Massimo F. ^{[30
]}

机构：

[1] IRCCS, Ctr Cardiol Monzino, Milan, Italy

[2] IRCCS, Multimed Spa, Osped S Giuseppe, Unita Operat Cardiol Riabilitat, Milan, Italy

[3] Univ Milan, Sezione Cardiovasc, Dipartimento Sci Clin & Comunita, Milan, Italy

[4] IRCCS, Ist Sci Veruno, Fdn Salvatore Maugeri, Div Cardiol Riabilitat, Veruno, Italy

[5] Ospedali Riuniti, Cardiovasc Dept, Trieste, Italy

[6] Univ Trieste, Trieste, Italy

[7] IRCCS, Inst Cassano Murge, S Maugeri Fdn, Div Cardiol, Bari, Italy

[8] UOC Cardiol Osped S Spirito, Roma Lungotevere Sassia 3, Rome, Italy

[9] CNR Reg Toscana, Fdn Gabriele Monasterio, Pisa, Italy

[10] Scuola Super Sant Anna, Inst Life Sci, Pisa, Italy

[11] Univ Brescia, Dept Med & Surg Specialties Radiol Sci & Publ Hlt, Cardiol, Brescia, Italy

[12] Ctr Cardiovasc, Azienda & Servizi Sanitari 1, Trieste, Italy

[13] Seconda Univ Napoli, Cardiol SUN, Osped Monaldi Azienda Colli, Naples, Italy

[14] IRCCS, Fdn Salvatore Maugeri, Ist Sci Tradate, Dipartimento Med & Riabilitaz Cardioresp,Unita Op, Tradate, Italy

[15] San Camillo Forlanini Hosp, Div Cardiol, Cardiac Arrhythmia Ctr, Rome, Italy

[16] San Camillo Forlanini Hosp, Cardiomyopathies Unit, Rome, Italy

[17] Univ Milan, IRCCS San Donato Hosp, Dept Med Sci, Cardiol, Milan, Italy

[18] Azienda Osped Riuniti, Cardiol Riabilitat, Ancona, Italy

[19] Univ Milano Bicocca, Dept Clin Med & Prevent, Milan, Italy

[20] S Luca Hosp, Dept Cardiol, Ist Auxol Italiano, Milan, Italy

[21] Sapienza Univ Roma, Dipartimento Med Clin & Mol, Rome, Italy

[22] Osped Ca Granda AO Niguarda, Dipartimento Cardiol A De Gasperis, Milan, Italy

[23] IRCCS SDN Ist Ric, Naples, Italy

[24] Univ Federico II Napoli, Dipartimento Sci Biomed Avanzate, Naples, Italy

[25] Univ Foggia, Dept Cardiol, Foggia, Italy

[26] Sapienza Rome Univ, Dipartimento Sci Cardiovasc Resp Nefrol Anestesio, Rome, Italy

[27] Univ Verona, Cardiol Sect, Dept Med, Verona, Italy

[28] IRCCS ISMETT, Dept Treatment & Study Cardiothorac Dis & Cardiot, Palermo, Italy

[29] G Saliceto Hosp, UOC Cardiol, Piacenza, Italy

[30] Scuola Super Sant Anna, Pisa, Italy

来源：

EUROPEAN JOURNAL OF INTERNAL MEDICINE | 2017年 / 37卷

关键词：

Anemia; Heart failure; Prognosis; SYSTEM; IMPACT;

D O I：

10.1016/j.ejim.2016.09.011

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Anemia is frequent in heart failure (HF), and it is associated with higher mortality. The predictive power of established HF prognostic parameters in anemic HF patients is unknown. Methods: Clinical, laboratory, echocardiographic and cardiopulmonary-exercise-test (CPET) data were analyzed in 3913 HF patients grouped according to hemoglobin (Hb) values. 248 (6%), 857 (22%), 2160 (55%) and 648 (17%) patients had very low (<11 g/dL), low (11-12 for females, 11-13 for males), normal (12-15 for females, 13-15 for males) and high (>15) Hb, respectively. Results: Median follow-up was 1363 days (606-1883). CPETs were always performed safely. Hb was related to prognosis (Hazard ratio (HR) = 0.864). No prognostic difference was observed between normal and high Hb groups. Peak oxygen consumption (VO2), ventilatory efficiency (VE/VCO2 slope), plasma sodium concentration, ejection fraction (LVEF), kidney function and Hb were independently related to prognosis in the entire population. Considering Hb groups separately, peakVO(2) (very low Hb HR = 0.549, low Hb HR = 0.613, normal Hb HR = 0.618, high Hb HR = 0.542) and LVEF (very low Hb HR = 0.49, low Hb HR = 0.692, normal Hb HR = 0.697, high Hb HR = 0.694) maintained their prognostic roles. High VE/VCO2 slope was associated with poor prognosis only in patients with low and normal Hb. Conclusions: Anemic HF patients have a worse prognosis, but CPET can be safely performed. PeakVO(2) and LVEF, but not VE/VCO2 slope, maintain their prognostic power also in HF patients with Hb < 11 g/dL, suggesting CPET use and a multiparametric approach in HF patients with low Hb. However, the prognostic effect of an anemia-oriented follow-up is unknown. (C) 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

引用

页码：56 / 63

页数：8

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