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• W1994804959 abstract "Chronic heart failure (CHF) is a common syndrome 1 affecting more than 20 million people world-wide and approximately 7 million people in the European community. The incidence and prevalence of CHF have been shown to increase sharply with age 2. Prognosis is poor; 12 week mortality was 14% in the recently reported Euroheart survey 3. Anaemia as a cofactor in CHF has not been well evaluated and its contribution is ill defined 4,5. The following factors have to be considered: Taking into consideration all of the above mentioned factors, anaemia favours the progression of heart failure. Anaemia has been recognised to exacerbate pre-existing heart failure 11. Furthermore recent literature suggests a far more important role of anaemia in the natural course of CHF. In addition, a vicious cycle between anaemia, chronic renal failure and exacerbation of heart failure can be assumed. Thus it seems logical, that Silverberg et al. 12,13 suggested treatment with a combination of erythropoietin and intravenous iron. This combination has been shown to be safe and effective in patients with CHF before starting dialysis as well as in patients on dialysis. Intravenous iron administration seems to be more effective than oral administration, possibly because of iron absorption disturbances in CHF patients. Intravenous iron therapy can reduce the need for high erythropoietin doses, which it might be preferable to avoid since this can lead to an increase in arterial pressure, which may not be desirable. Improvement of symptoms of CHF and exercise capacity has also been observed 12–14. These benefits might be more pronounced in the early stages of CHF, than in patients with end stage CHF under dialysis and recombinant erythropoietin therapy 15. If treatment with erythropoietin and iron is preceded by exclusion of other causes of anaemia, for example intestinal blood loss or fluid overload, it might be quite effective for improvement of symptoms and reduction of left ventricular size 5. Prognostic benefits are unproven, but cannot be excluded. Recent studies have investigated a novel erythropoiesis stimulating protein (NESP) which has a three-times longer half-life due to addition of two extra carbohydrate chains 16. NESP is a hyperglycosylated analogue of recombinant human erythropoietin that was used in 1500 patients for stimulation of erythropoiesis. In conclusion, moderate and severe anaemia of any origin can exacerbate CHF. Patients with heart failure may benefit from therapy of anaemia. Favourable influences on the long-term course are possible but so far unproven. Further studies are needed." @default.
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• W1994804959 date "2003-01-01" @default.
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• W1994804959 title "Anaemia in heart failure: its diagnosis and management" @default.
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• W1994804959 doi "https://doi.org/10.1016/s1388-9842(02)00161-7" @default.
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