Effect of erythropoietin on exercise capacity in anemic patients with advanced heart failure

Mancini, Donna; Kunavarapu, Chandra

doi:10.1046/j.1523-1755.64.s87.8.x

Cited by 24 publications

(13 citation statements)

References 38 publications

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“…Epo is a multifunctional trophic factor with different sites of endogenous expression, a tissue-specific regulation, and several mechanisms of action (59 -62 MSCs may be similar to that of intermittent pulsed rhEpo, there may be additional clinical benefit on organ systems that express the Epo receptor, such as on myocardium. Epo's many effects include cardioprotection and improved myocardial function (62,(65)(66)(67). Therefore, the greater swimming time in CRF mice that received Epo-secreting MSCs may have arisen not only from the resulting increase in Hct but also from a direct biologic effect on myocardium that would be observed in a setting of continuous Epo delivery, such as provided by our neo-organoid system.…”

Section: Discussionmentioning

confidence: 99%

Erythropoietin Delivery by Genetically Engineered Bone Marrow Stromal Cells for Correction of Anemia in Mice with Chronic Renal Failure

Eliopoulos¹,

Gagnon²,

François³

et al. 2006

Journal of the American Society of Nephrology

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The goal of this research was to develop a strategy to couple stem cell and gene therapy for in vivo delivery of erythropoietin (Epo) for treatment of anemia of ESRD. It was shown previously that autologous bone marrow stromal cells (MSCs) can be genetically engineered to secrete pharmacologic amounts of Epo in normal mice. Therefore, whether anemia in mice with mild to moderate chronic renal failure (CRF) can be improved with Epo gene-modified MSCs (Epo ؉ MSCs) within a subcutaneous implant was examined. A cohort of C57BL/6 mice were rendered anemic by right kidney electrocoagulation and left nephrectomy. In these CRF mice, the hematocrit (Hct) dropped from a prenephrectomy baseline of approximately 55% to 40% after induction of renal failure. MSCs from C57BL/6 donor mice were genetically engineered to secrete murine Epo at a rate of 3 to 4 units of Epo/10 6 cells per 24 h, embedded in a collagen-based matrix, and implanted subcutaneously in anemic CRF mice. It was observed that Hct increased after administration of Epo ؉ MSCs, according to cell dose. Implants of 3 million Epo ؉ MSCs per mouse had no effect on Hct, whereas 10 million led to a supraphysiologic effect. The Hct of CRF mice that received 4.5 or 7.5 million Epo ؉ MSCs rose to a peak 54 ؎ 4.0 or 63 ؎ 5.5%, respectively, at 3 wk after implantation and remained above 48 or 54% for >19 wk. Moreover, mice that had CRF and received Epo ؉ MSCs showed significantly greater swimming exercise capacity. In conclusion, these results demonstrate that subcutaneous implantation of Epo-secreting genetically engineered MSCs can correct anemia that occurs in a murine model of CRF.

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Section: Discussionmentioning

confidence: 99%

Erythropoietin Delivery by Genetically Engineered Bone Marrow Stromal Cells for Correction of Anemia in Mice with Chronic Renal Failure

Eliopoulos¹,

Gagnon²,

François³

et al. 2006

Journal of the American Society of Nephrology

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“…Recent studies investigated a correlation between anemia and HF severity and showed that there was an improvement in the ejection fraction (EF), functional class and exercise capacity when anemia improved [24][25][26] .…”

Section: Discussionmentioning

confidence: 99%

Avaliação de fatores prognósticos da insuficiência cardíaca em pacientes encaminhados para avaliação de transplante cardíaco

Areosa¹,

Almeida²,

Carvalho³

et al. 2007

Arq. Bras. Cardiol.

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SummaryObjectives: To evaluate the survival of patients with heart failure submitted to cardiac transplantation screening as well as identify poor prognostic factors using a risk score to identify patients with higher death risk.Methods: 330 male and female patients aged 12 to 74 years old, referred for heart transplantation from January 1986 to November 2001 were evaluated. Clinical, laboratory, electrocardiographic, Holter monitoring, echocardiographic and radionuclide ventriculography data were analyzed.Results: The median follow up period was 5 years; patients' survival rate was 84.5% in the first year, 74.3% in the second year, 68.9% in the third year and 60.5% in the fifth year. The prognostic variables selected through the univariate analysis were: age, Chagas' disease etiology for cardiomyopathy, NYHA functional classes III and IV, orthopnea, systolic blood pressure, mean blood pressure, pulse pressure, plasma urea, sodium, glucose, albumin, bilirubin, hemoglobin, and mean heart rate. The prognostic variables at the multivariate analysis were: ejection fraction, blood urea, and hemoglobin. The risk score: RR=exp[(-0.0942401 x ejection fraction) + (0.0105207 x blood urea) + (-0.2974991 x hemoglobin) + (-0.0132898 x age) + (-0.0099115 x blood glucose)] discriminated the population with a higher death risk.Conclusion: Patients' survival was satisfactory despite heart failure severity, suggesting they can be maintained on optimized clinical treatment until persistent clinical deterioration takes place. Ejection fraction, ventricular diameters, and clinical functional class alone should not be used as an indication for heart transplantation. The risk score could help discriminate the population with the poorest prognosis. (Arq Bras Cardiol 2007;88(6):590-595)

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“…Çalışmamızda hastaların yarıya yakınında anemi gözlenmiştir. Kalp yetersizliği olan hastalarda aneminin tedavi edilmesi ile kalp fonksiyonlarında ve hastanın egzersiz kapasitesinde düzel-me, hastaneye yatış sayısında ve böbrek fonksiyonlarının bozulmasında azalma olduğu bilinmektedir (33,34). Yakın zamanda yayınlanan ve 600.000 adet AKY'li hastanın taburculuk bilgilerinin değerlendirildiği kayıt tarama çalışmasında anemi sıklığı %27.1 olarak saptanmış ve anemi, böbrek yetersizliği ve kan transfüz-yonunun AKY'li hastalarda hastanede kalış süresinin ve hastane içi ölümün bağımsız belirleyicisi oldukları bildirilmiştir (35).…”

Section: Laboratuvar Bulgularıunclassified

Evaluation of clinical and demographic characteristics and their association with length of hospital stay in patients admitted to cardiac intensive care unit with the diagnosis of acute heart failure

Şahin

Doğan²,

Özdemi̇r³

et al. 2012

Anadolu Kardiyol Derg

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Akut kalp yetersizliği nedeni ile kardiyoloji yoğun bakım ünitesine yatırılan hastaların klinik ve demografik özelliklerinin ve bu özelliklerin hastanede kalış süresi ile ilişkisinin incelenmesiEvaluation of clinical and demographic characteristics and their association with length of hospital stay in patients admitted to cardiac intensive care unit with the diagnosis of acute heart failure ABSTRACTObjective: Despite increasing incidence, data regarding clinical and demographic characteristics of patients with acute heart failure (AHF) admitted to cardiac intensive care unit (ICU) are inconclusive. The aim of this study was to assess the presentation characteristics and factors determining the length of hospital stay in this particular patient population. Methods: We conducted a single-center, prospective study involving 150 patients hospitalized to cardiac ICU with the primary diagnosis of AHF. Chi-square and Student t tests were used for the analysis of categorical and continuous variables, respectively. Linear regression analysis (LRA) was used to determine the factors affecting the length of hospital stay.Results: Forty-nine percent of the patients had new-onset AHF and 25% had preserved left ventricular ejection fraction (LVEF). In 25.3% of all patients and 46.6% of the patients with new-onset HF the precipitating factor was acute coronary syndrome. Atrial fibrillation and valvular heart disease as precipitating factors were more common in patients with preserved EF, when compared to low EF group. LRA showed that presence of anemia [β=1.62; 95% CI 0.08-3.15; p=0.039)] and severe mitral regurgitation (β=2.55; 95% CI 0.06-5.05; p=0.045) and systolic blood pressure (β=-0.03; 95% CI -0.06 --0.002; p=0.039) and blood urea nitrogen (β=0.034; 95% CI 0.006 -0.06; p=0.016) were the independent predictors of length of stay. GirişKalp yetersizliği (KY), ülkemizde ve tüm Dünya'da en önemli ölüm nedenleri arasında yer almaktadır (1-4). Altmış beş yaş üstü hastalarda hastaneye yatışların en sık nedeni akut KY'dir (AKY) (5). Tedavi yöntemlerindeki ilerlemeler sonucunda kronik KY nedeniyle ayaktan takip edilen hastaların ölüm oranlarında azalma sağlanmasına rağmen, AKY nedeni ile hastaneye yatırılan hastaların hastane içi ve taburcu sonrası ölüm oranlarındaki yükseklik devam etmektedir (6). Kalp yetersizliği nedeni ile hastaneye yatırı-lan hastaların yaklaşık %50'si taburcu olduktan sonra ilk yıl içinde aynı tanı ile tekrar hastaneye yatırılmaktadır (7). Bu hastaların bir yıl içinde kaybedilme oranları ayaktan takip edilen hastalardan daha yüksektir (8).Yüksek görülme sıklığına, kötü seyrine ve ekonomik yönden oluşturduğu ağır yüke rağmen AKY nedeniyle hastaneye yatırı-lan hastalarla ilgili epidemiyolojik çalışmalar ancak yakın zamanda yapılmıştır (9-13).Bu hasta grubuna ait ülkemizdeki verilerin yetersizliğini dikkate alarak kardiyoloji yoğun bakım ünitemize AKY nedeni ile yatırılan hastaların demografik ve klinik özelliklerinin ve hastanede yatış süresini etkileyen faktörlerin incelendiği ileriye dönük, gözlemsel bir ça...

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Effect of erythropoietin on exercise capacity in anemic patients with advanced heart failure

Cited by 24 publications

References 38 publications

Erythropoietin Delivery by Genetically Engineered Bone Marrow Stromal Cells for Correction of Anemia in Mice with Chronic Renal Failure

Erythropoietin Delivery by Genetically Engineered Bone Marrow Stromal Cells for Correction of Anemia in Mice with Chronic Renal Failure

Avaliação de fatores prognósticos da insuficiência cardíaca em pacientes encaminhados para avaliação de transplante cardíaco

Evaluation of clinical and demographic characteristics and their association with length of hospital stay in patients admitted to cardiac intensive care unit with the diagnosis of acute heart failure

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