European Heart Journal Advance Access originally published online on December 21, 2006
European Heart Journal 2007 28(2):143-145; doi:10.1093/eurheartj/ehl434
© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Variable aetiologies contributing to the anaemia of systolic heart failure are important to individual patient management
1 University Department of Medicine, Sandwell and West Birmingham NHS Trust, City Hospital, Dudley Road, Birmingham B18 7QH, UK
2 Department of Cardiology, Sandwell and West Birmingham NHS Trust, City Hospital, Dudley Road, Birmingham B18 7QH, UK
* Corresponding author. Tel: +44 121 507 4476 5080; fax: +44 121 554 4854. E-mail address: robert.macfadyen@swbh.nhs.uk
This editorial refers to ‘Anaemia in chronic heart failure is not only related to impaired renal perfusion and blunted erythropoietin production, but to fluid retention as well’
by B.D. Westenbrink et al., on page 166
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The anaemia of chronic left ventricular systolic dysfunction (LVSD) or systolic heart failure is common, increases over time,1 and is linked with a bad clinical outcome. It is often considered an expression of the chronic vascular inflammation of endstage disease similar to that seen in conjunction with many other chronic disease states. Failure of haematinic function, particularly renal erythropoietin (Epo) synthesis and release, is also seen as a key mechanism and is cited as a major justification for considering exogenous Epo therapy in this disease. Westenbrink et al.2 from Groningen contribute a simple but critical clinical paper highlighting that variable mechanisms contribute to this clinical setting. By defining these carefully, Westenbrink shows that notwithstanding the impact of altered Epo kinetics and dynamics, many of these patients might also have ‘simple’ dilutional anaemia related to poorly perceived and asymptomatic fluid imbalance. This simple
Haematological aspects of anaemia in LVSD
Epo kinetics as the dominant mechanism for anaemia in LVSD?
Where does fluid balance and renal resistance to diuresis fit in?
The importance of determining volume status in LVSD anaemia and in LVSD in general
Coordinated therapy for advanced anaemic LVSD
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- Anaemia in chronic heart failure is not only related to impaired renal perfusion and blunted erythropoietin production, but to fluid retention as well
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EHJ 2007 28: 166-171.[Abstract] [FREE Full Text]
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