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Siddiqui SW, Ashok T, Patni N, Fatima M, Lamis A, Anne KK. Anemia and Heart Failure: A Narrative Review. Cureus 2022; 14:e27167. [PMID: 36017290 PMCID: PMC9393312 DOI: 10.7759/cureus.27167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2022] [Indexed: 11/06/2022] Open
Abstract
Anemia in heart failure patients is a relatively common finding and has been linked with an increased risk of hospital admissions, morbidities, and significant mortality making its correction a significant factor in improving the quality of life and clinical outcomes in those suffering from it. This review article has discussed the multifactorial pathophysiology, including iron deficiency, longstanding inflammation, abnormal levels of human erythropoietin (Epo), and the abnormal activation of the renin-angiotensin-aldosterone system (RAAS) being the most significant. The diagnostic guidelines as well as research-based management modalities specifically with iron supplements and erythropoietin stimulating agents have also been discussed, although research done in this area has been limited and shown conflicting results.
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Kaya H, Şahin A, Güneş H, Bekar L, Çelik A, Çavuşoğlu Y, Çaldır V, Güngör H, Yılmaz MB. Increased frequency of occurrence of bendopnea is associated with poor outcomes in heart failure outpatients. Acta Cardiol 2021; 76:878-886. [PMID: 32812491 DOI: 10.1080/00015385.2020.1797303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Relationship between the frequency of occurrence of bendopnea during the daily life of heart failure (HF) outpatients and clinical outcomes has never been evaluated before. METHODS Turkish Research Team-Heart Failure (TREAT-HF) is a network between HF centres, which undertakes multicentric observational studies in HF. Herein, the data including stable 573 HF patients with reduced ejection fraction out of seven HF centres were presented. A questionnaire was filled by the patients, with the question 'Do you experience shortness of breath while tying your shoelace?', assessing the presence and frequency of bendopnea. RESULTS To the question related to bendopnea, 48% of the patients answered 'yes, every time', 31% answered 'yes, sometimes', and 21% answered 'No'. Patients were followed for an average of 24 ± 14 months, and the patients who answered 'yes, every time' and 'yes, sometimes' to the bendopnea question were found having increased risk for both HF-related hospitalisations (HR:3.2, p < .001- HR:2.8, p = .005) and composite outcome consisting of 'HF-related hospitalisations and all-cause death in the multi-variate analysis (HR:3.1, p < .001- HR:3.0, p < .001). Kaplan Meier analysis for HF-related hospitalisation, all-cause death, and the composite of these were provided for these three groups, yielding significant and graded divergence curves with the best prognosis in 'no' group, with the moderate prognosis in 'sometimes' group, and with the worst prognosis in the 'every time' group. CONCLUSION For the first time in the literature, our study shows that the increased frequency of bendopnea occurrence in daily life is associated with poor outcomes in HF outpatients.
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Affiliation(s)
- Hakkı Kaya
- Department of Cardiology, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Anıl Şahin
- Antalya Training and Research Hospital, Cardiology Clinics, Antalya, Turkey
| | - Hakan Güneş
- Department of Cardiology, Faculty of Medicine, Sutcu Imam University, Kahramanmaras, Turkey
| | - Lütfü Bekar
- Department of Cardiology, Faculty of Medicine, Hitit University, Çorum, Turkey
| | - Ahmet Çelik
- Department of Cardiology, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Yüksel Çavuşoğlu
- Department of Cardiology, Faculty of Medicine, Osmangazi University, Eskisehir, Turkey
| | - Vedat Çaldır
- Cardiology Clinic, Baskent University Konya Hospital, Konya, Turkey
| | - Hasan Güngör
- Department of Cardiology, Faculty of Medicine, Adnan Menderes University, Aydın, Turkey
| | - Mehmet Birhan Yılmaz
- Department of Cardiology, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey
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Gaborit FS, Kistorp C, Kümler T, Hassager C, Tønder N, Iversen K, Hansen PM, Kamstrup PR, Faber J, Køber L, Schou M. Diagnostic utility of MR-proANP and NT-proBNP in elderly outpatients with a high risk of heart failure: the Copenhagen heart failure risk study. Biomarkers 2020; 25:248-259. [DOI: 10.1080/1354750x.2020.1732466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | - Caroline Kistorp
- Department of Endocrinology,Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Kümler
- Department of Cardiology, Herlev and Gentofte University Hospital, Herlev, Denmark
| | - Christian Hassager
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Cardiology, Rigshospitalet, Copenhagen, Denmark
| | - Niels Tønder
- Department of Cardiology, North Zealand Hospital, Hillerød, Denmark
| | - Kasper Iversen
- Department of Cardiology, Herlev and Gentofte University Hospital, Herlev, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Pernille Mørk Hansen
- Department of Nephrology, Herlev and Gentofte University Hospital, Herlev, Denmark
| | - Pia Rørbaek Kamstrup
- Department of Clinical Chemistry Department K, Herlev and Gentofte University Hospital, Herlev, Denmark
| | - Jens Faber
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Endocrinology, Herlev and Gentofte University Hospital, Herlev, Denmark
| | - Lars Køber
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Cardiology, Rigshospitalet, Copenhagen, Denmark
| | - Morten Schou
- Department of Cardiology, Herlev and Gentofte University Hospital, Herlev, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Lelli D, Antonelli Incalzi R, Pedone C. Hemoglobin Concentration Influences N-Terminal Pro B-Type Natriuretic Peptide Levels in Hospitalized Older Adults with and without Heart Failure. J Am Geriatr Soc 2017; 65:2369-2373. [DOI: 10.1111/jgs.14959] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Diana Lelli
- Area di Geriatria; Policlinico Universitario Campus Bio-Medico di Roma; Rome Italy
| | | | - Claudio Pedone
- Area di Geriatria; Policlinico Universitario Campus Bio-Medico di Roma; Rome Italy
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Oremus M, Don-Wauchope A, McKelvie R, Santaguida PL, Hill S, Balion C, Booth R, Brown JA, Ali U, Bustamam A, Sohel N, Raina P. BNP and NT-proBNP as prognostic markers in persons with chronic stable heart failure. Heart Fail Rev 2015; 19:471-505. [PMID: 24986335 DOI: 10.1007/s10741-014-9439-6] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Prognosis permits clinicians to separate persons with heart failure (HF) into subgroups based on likely health outcomes. Treatment is partly guided by these likely outcomes. This systematic review explores whether brain natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) are independent predictors of prognosis in persons with chronic stable HF. We electronically searched Medline, Embase, AMED, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and CINAHL for English-language articles published between 1989 and mid-2012. We utilized trained reviewers and standardized forms to screen articles for inclusion and extracted data from included articles. All included studies were summarized in narrative and tabular form. We used the Hayden criteria to assess the risk of bias. Sixteen BNP publications and 88 NT-proBNP publications were included in the systematic review. BNP was positively associated with all-cause and HF mortality. NT-proBNP was positively associated with all-cause and cardiovascular mortality. BNP and NT-proBNP levels are useful for estimating prognosis in persons with chronic stable HF. Further research is required to establish optimal cutpoints and to assess whether prognostic effects differ by age, sex, or time period.
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Affiliation(s)
- Mark Oremus
- Department of Clinical Epidemiology and Biostatistics, McMaster University, 1280 Main Street West, MIP Suite 309A, Hamilton, ON, L8S 4K1, Canada
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Don-Wauchope AC, Santaguida PL, Oremus M, McKelvie R, Ali U, Brown JA, Bustamam A, Sohel N, Hill SA, Booth RA, Balion C, Raina P. Incremental predictive value of natriuretic peptides for prognosis in the chronic stable heart failure population: a systematic review. Heart Fail Rev 2014; 19:521-40. [DOI: 10.1007/s10741-014-9443-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Jensen LJN, Kistorp C, Bjerre M, Raymond I, Flyvbjerg A. Plasma calprotectin levels reflect disease severity in patients with chronic heart failure. Eur J Prev Cardiol 2011; 19:999-1004. [DOI: 10.1177/1741826711421078] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Louise JN Jensen
- The Medical Research Laboratories, Institute of Clinical Medicine, Aarhus University and Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Caroline Kistorp
- Department of Endocrinology and Internal Medicine, Herlev University Hospital, Herlev, Denmark
| | - Mette Bjerre
- The Medical Research Laboratories, Institute of Clinical Medicine, Aarhus University and Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Ilan Raymond
- Department of Cardiology and Endocrinology, Frederiksberg University Hospital, Frederiksberg, Denmark
| | - Allan Flyvbjerg
- The Medical Research Laboratories, Institute of Clinical Medicine, Aarhus University and Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
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Aleksova A, Barbati G, Merlo M, Stolfo D, Sabbadini G, Di Lenarda A, Sinagra G. Deleterious impact of mild anemia on survival of young adult patients (age 45 ± 14 years) with idiopathic dilated cardiomyopathy: Data from the Trieste Cardiomyopathies Registry. Heart Lung 2011; 40:454-61. [DOI: 10.1016/j.hrtlng.2010.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2009] [Revised: 05/21/2010] [Accepted: 06/01/2010] [Indexed: 10/19/2022]
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Mansour IN, Napan S, Tarek Alahdab M, Stamos TD. Carbohydrate Antigen 125 Predicts Long-Term Mortality in African American Patients With Acute Decompensated Heart Failure. ACTA ACUST UNITED AC 2010; 16:15-20. [DOI: 10.1111/j.1751-7133.2009.00110.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hamaguchi S, Tsuchihashi-Makaya M, Kinugawa S, Yokota T, Takeshita A, Yokoshiki H, Tsutsui H, The JCARE-CARD Investigators. Anemia is an Independent Predictor of Long-Term Adverse Outcomes in Patients Hospitalized With Heart Failure in Japan A Report From the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD). Circ J 2009; 73:1901-8. [DOI: 10.1253/circj.cj-09-0184] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Sanae Hamaguchi
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
| | - Miyuki Tsuchihashi-Makaya
- Department of Clinical Research and Informatics, Research Institute, International Medical Center of Japan
| | - Shintaro Kinugawa
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
| | - Takashi Yokota
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
| | | | - Hisashi Yokoshiki
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
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Faraz HA, Zafar SF, Ghali JK. Anemia and the potential role of erythropoiesis-stimulating agents in heart failure. Curr Heart Fail Rep 2008; 5:83-90. [DOI: 10.1007/s11897-008-0014-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Groenveld HF, Januzzi JL, Damman K, van Wijngaarden J, Hillege HL, van Veldhuisen DJ, van der Meer P. Anemia and Mortality in Heart Failure Patients. J Am Coll Cardiol 2008; 52:818-27. [PMID: 18755344 DOI: 10.1016/j.jacc.2008.04.061] [Citation(s) in RCA: 531] [Impact Index Per Article: 33.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2008] [Revised: 04/23/2008] [Accepted: 04/28/2008] [Indexed: 11/26/2022]
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Astor BC, Yi S, Hiremath L, Corbin T, Pogue V, Wilkening B, Peterson G, Lewis J, Lash JP, Van Lente F, Gassman J, Wang X, Bakris G, Appel LJ, Contreras G. N-terminal prohormone brain natriuretic peptide as a predictor of cardiovascular disease and mortality in blacks with hypertensive kidney disease: the African American Study of Kidney Disease and Hypertension (AASK). Circulation 2008; 117:1685-92. [PMID: 18362234 DOI: 10.1161/circulationaha.107.724187] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Higher levels of N-terminal prohormone brain-type natriuretic peptide (NT-proBNP) predict cardiovascular disease (CVD) in several disease states, but few data are available in patients with chronic kidney disease or in blacks. METHODS AND RESULTS The African American Study of Kidney Disease and Hypertension trial enrolled hypertensive blacks with a glomerular filtration rate of 20 to 65 mL x min(-1) x 1.73 m(-2) and no other identified cause of kidney disease. NT-proBNP was measured with a sandwich chemiluminescence immunoassay (coefficient of variation 2.9%) in 994 African American Study of Kidney Disease and Hypertension participants. NT-proBNP was categorized as undetectable, low, moderate, or high. Proteinuria was defined as 24-hour urinary protein-creatinine ratio >0.22. A total of 134 first CVD events (CVD death or hospitalization for coronary artery disease, heart failure, or stroke) occurred over a median of 4.3 years. Participants with high NT-proBNP were much more likely to have a CVD event than participants with undetectable NT-proBNP after adjustment (relative hazard 4.0 [95% confidence interval [CI] 2.1 to 7.6]). A doubling of NT-proBNP was associated with a relative hazard of 1.3 (95% CI 1.0 to 1.6) for coronary artery disease, 1.7 (95% CI 1.4 to 2.2) for heart failure, 1.1 (95% CI 0.9 to 1.4) for stroke, and 1.8 (95% CI 1.4 to 2.4) for CVD death. The association of NT-proBNP with CVD events was significantly stronger (P(interaction)=0.05) in participants with than in those without proteinuria. Higher NT-proBNP was not associated with renal disease progression. CONCLUSIONS These results suggest that elevated NT-proBNP levels are associated with higher CVD risk among blacks with hypertensive kidney disease. This association may be stronger in individuals with significant proteinuria.
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Affiliation(s)
- B C Astor
- Welch Center for Prevention, Epidemiology and Clinical Research, 2024 E Monument St, Suite 2-600, Baltimore, MD 21205, USA.
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