[Anemia and heart function]

Anemia typically leads to a state of hyperkinetic circulation with tachycardia, reduced peripheral resistance, increased stroke volume chamber dilatation, and finally to the development of left ventricular hypertrophy. These changes are usually well tolerated by patients with a healthy heart. In patients with heart diseases, however, anemia may lead to deterioration of ventricular performance and to increased morbidity and mortality respectively. Specific changes in cardiac function may arise depending on the causes of anemia such as myocardial iron deposition and dilatative cardiomyopathy in hemolytic anemia or alterations of homeostasis and reduction of cardiac function in renal anemia. With respect to cardiac function the cause of anemia must be corrected as far as possible and hemoglobin kept over a level of 10 g/dl. As far as renal anemia is concerned this goal can be reached by regular administration of erythropoietin and/or iron respectively.