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Anemia and heart failure: a cause of progression or only a consequence?
Marco Metra1, Savina Nodari, Tania Bordonali
1Section of Cardiovascular Diseases Department of Experimental and Applied Medicine, University of Brescia - Spedali Civili, Brescia - Italy.
Abstract:
Anemia is one of the most frequent co-morbidities in the patients with heart failure. Its prevalence increases from 4-7% in the subjects with asymptomatic left ventricular dysfunction to >30% in the patients with severe heart failure. Renal insufficiency, activation of inflammatory mediators, and treatment with renin-angiotensin antagonists seem to be its main determinants. The results of many studies agree in showing that anemia is a powerful independent determinant of survival in patients with heart failure. However, the mechanisms of this relation are still incompletely understood. Moreover a favourable effect on prognosis of the correction of anemia has not been shown, yet, and also controlled studies assessing its effects on exercise tolerance have yielded controversial results.
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