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 (b11 g/dL), low (11–12 for females, 11–13 for males), normal (12–15 for females, 13–15 for males) and high (N15) 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 popula- tion. Considering Hb groups separately, peakVO2 (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. PeakVO2 and LVEF, but not VE/VCO2 slope, maintain their prognostic power also in HF patients with Hb b 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.

Heart failure and anemia: Effects on prognostic variables / Cattadori, G; Agostoni, P; Corrà, U; Sinagra, G; Veglia, F; Salvioni, E; Bonomi, A; La Gioia, R; Scardovi, Ab; Ferraironi, A; Emdin, M; Metra, M; Di Lenarda, A; Limongelli, G; Raimondo, R; Re, F; Guazzi, M; Belardinelli, R; Parati, G; Caravita, S; Magrì, D; Lombardi, C; Frigerio, M; Oliva, F; Girola, D; Mezzani, A; Farina, S; Mapelli, M; Scrutinio, D; Pacileo, G; Apostolo, A; Iorio, A; Paolillo, S; Filardi, Pp; Gargiulo, P; Bussotti, M; Marchese, G; Correale, M; Badagliacca, R; Sciomer, S; Palermo, P; Contini, M; Giannuzzi, P; Battaia, E; Cicoira, M; Clemenza, F; Minà, C; Binno, S; Passino, C; Piepoli, M. - In: EUROPEAN JOURNAL OF INTERNAL MEDICINE. - ISSN 1879-0828. - 37:(2017), pp. 56-63.

Heart failure and anemia: Effects on prognostic variables.

Corrà U;Paolillo S;Filardi PP
Membro del Collaboration Group
;
Gargiulo P;Piepoli M
2017

Abstract

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 (b11 g/dL), low (11–12 for females, 11–13 for males), normal (12–15 for females, 13–15 for males) and high (N15) 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 popula- tion. Considering Hb groups separately, peakVO2 (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. PeakVO2 and LVEF, but not VE/VCO2 slope, maintain their prognostic power also in HF patients with Hb b 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.
2017
Heart failure and anemia: Effects on prognostic variables / Cattadori, G; Agostoni, P; Corrà, U; Sinagra, G; Veglia, F; Salvioni, E; Bonomi, A; La Gioia, R; Scardovi, Ab; Ferraironi, A; Emdin, M; Metra, M; Di Lenarda, A; Limongelli, G; Raimondo, R; Re, F; Guazzi, M; Belardinelli, R; Parati, G; Caravita, S; Magrì, D; Lombardi, C; Frigerio, M; Oliva, F; Girola, D; Mezzani, A; Farina, S; Mapelli, M; Scrutinio, D; Pacileo, G; Apostolo, A; Iorio, A; Paolillo, S; Filardi, Pp; Gargiulo, P; Bussotti, M; Marchese, G; Correale, M; Badagliacca, R; Sciomer, S; Palermo, P; Contini, M; Giannuzzi, P; Battaia, E; Cicoira, M; Clemenza, F; Minà, C; Binno, S; Passino, C; Piepoli, M. - In: EUROPEAN JOURNAL OF INTERNAL MEDICINE. - ISSN 1879-0828. - 37:(2017), pp. 56-63.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/721878
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