Blood levels of erythropoietin in congestive heart failure and correlation with clinical, hemodynamic, and hormonal profiles

Volpe, Massimo; Tritto, C; Testa, Ugo; Rao, Maria Assunta Elena; Martucci, Robert; Mirante, A; Enea, Iolanda; Russo, Rosaria; Rubattu, Speranza; Condorelli, Gianluigi; Cangianiello, Sara; Trimarco, Bruno; Peschle, Cesare; Condorelli, M

doi:10.1016/0002-9149(94)90905-9

Cited by 130 publications

(106 citation statements)

References 24 publications

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“…25) In CHF patients, renal blood flow and eGFR are decreased 24) and the erythropoietin level is increased with the severity of heart failure. 26) However, this increase could not raise hemoglobin to levels high enough to obtain adequate oxygenation for CHF patients, and ESAs were used for the therapeutic target in CHF patients with anemia. Although some studies using ESAs performed in single center trials showed improvement of NYHA functional class and echocardiographic data in CHF patients with anemia, 6,7) the latest multicenter randomized, double blind, placebo-controlled trial did not yield the expected results.…”

Section: Discussionmentioning

confidence: 99%

Adaptive Servo-Ventilation Therapy Improves Long-Term Prognosis in Heart Failure Patients With Anemia and Sleep-Disordered Breathing

et al. 2014

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SummarySleep disordered breathing (SDB) and anemia influences the progression of chronic heart failure (CHF). Adaptive servo-ventilation (ASV) is an effective therapeutic device for treatment of CHF, however, the impacts of ASV on CHF patients with or without anemia remain unclear.A total of 139 patients with CHF and SDB were divided into two groups: those treated with ASV (n = 53) and without ASV (n = 86). All patients were prospectively followed after discharge with the endpoints of cardiac death or progressive heart failure requiring rehospitalization. There were 65 patients (47%) with anemia among all subjects. The apnea hypopnea index was improved, and plasma BNP and high sensitive C-reactive protein levels were decreased in both groups with and without anemia by ASV therapy. The Kaplan-Meier survival curve demonstrated that the cardiac event-free rate in patients with ASV was significantly higher than in those without ASV in the anemia group (P = 0.008). However, in the non-anemia group, the cardiac event-free rate was similarly high in patients both with and without ASV (P = 0.664). Multivariate Cox proportional hazard analysis demonstrated that ASV use was an independent predictor of cardiac events in the anemia group (P = 0.0308), but not in the non-anemia group.ASV treatment for CHF and SDB has more favorable impacts in patients with anemia than in those without anemia. (Int Heart J 2014; 55: 342-349)

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Section: Discussionmentioning

confidence: 99%

Adaptive Servo-Ventilation Therapy Improves Long-Term Prognosis in Heart Failure Patients With Anemia and Sleep-Disordered Breathing

et al. 2014

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“…This occurs because treatment with ACE inhibitors is associated with higher recombinant human Epo (rhEpo) requirements (whereas withdrawal of ACE inhibitors decreases rhEpo doses), reflecting the direct effect of angiotensin II on erythropoiegenesis (89). Exceptions to the link of renin-angiotensin system activation and increased hematocrit are often cases in which increment of red blood cells mass are masked by volume expansion (i.e., in patients with severe heart failure) (90).…”

Section: Interplay Of Renin-angiotensin and Epo Systemsmentioning

confidence: 99%

Physiology of the Renal Interstitium

Zeisberg

Kalluri

2015

Clinical Journal of the American Society of Nephrology

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Long overlooked as the virtual compartment and then strictly characterized through descriptive morphologic analysis, the renal interstitium has finally been associated with function. With identification of interstitial reninand erythropoietin-producing cells, the most prominent endocrine functions of the kidney have now been attributed to the renal interstitium. This article reviews the functional role of renal interstitium.

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“…Particularly, these studies have shown a possible involvement of the renin angiotensin system in the genesis of erythrocytosis observed following a kidney transplant 191 or in association with congestive heart failure, 192 chronic obstructive pulmonary disease, 193,194 essential, malignant, or renovascular hypertension [195][196][197] or with chronic hemodialysis. 198,199 The pathogenesis of erythrocytosis observed in these conditions is complex in that erythropoietin, angiotensin II and insulin-like growth factor I are all involved.…”

Section: Apoptotic Mechanisms In the Genesis Of Erythrocytosis Associmentioning

confidence: 99%

Apoptotic mechanisms in the control of erythropoiesis

2004

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Erythropoiesis is a complex multistep process encompassing the differentiation of hemopoietic stem cells to mature erythrocytes. The steps involved in this complex differentiation process are numerous and involve first the differentiation to early erythoid progenitors (burst-forming units-erythroid, BFU-E), then to late erythroid progenitors (colony-forming unitserythroid) and finally to morphologically recognizable erythroid precursors. A key event of late stages of erythropoiesis is nuclear condensation, followed by extrusion of the nucleus to produce enucleated reticulocytes and finally mature erythrocytes. During the differentiation process, the cells became progressively sensitive to erythropoietin that controls both the survival and proliferation of erythroid cells.A normal homeostasis of the erythropoietic system requires an appropriate balance between the rate of erythroid cell production and red blood cell destruction. Growing evidences outlined in the present review indicate that apoptotic mechanism play a relevant role in the control of erythropoiesis under physiologic and pathologic conditions. Withdrawal of erythropoietin or stimulation of death receptors such as Fas or TRAIL-Rs leads to activation of a subset of caspases-3, -7 and -8, which then cleave the transcription factors GATA-1 and TAL-1 and trigger apoptosis. In addition, there is evidence that a number of caspases are physiologically activated during erythroid differentiation and are functionally required for erythroid maturation. Several caspase substrates are cleaved in differentiating cells, including the protein acinus whose activation by cleavage is required for chromatin condensation.The studies on normal erythropoiesis have clearly indicated that immature erythroid precursors are sensitive to apoptotic triggering mediated by activation of the intrinsic and extrinsic apoptotic pathways. These apoptotic mechanisms are frequently exacerbated in some pathologic conditions, associated with the development of anemia (ie, thalassemias, multiple myeloma, myelodysplasia, aplastic anemia).The considerable progress in our understanding of the apoptotic mechanisms underlying normal and pathologic erythropoiesis may offer the way to improve the treatment of several pathologic conditions associated with the development of anemia.

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Blood levels of erythropoietin in congestive heart failure and correlation with clinical, hemodynamic, and hormonal profiles

Cited by 130 publications

References 24 publications

Adaptive Servo-Ventilation Therapy Improves Long-Term Prognosis in Heart Failure Patients With Anemia and Sleep-Disordered Breathing

Adaptive Servo-Ventilation Therapy Improves Long-Term Prognosis in Heart Failure Patients With Anemia and Sleep-Disordered Breathing

Physiology of the Renal Interstitium

Apoptotic mechanisms in the control of erythropoiesis

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