Relation of anemia to diastolic heart failure and the effect on outcome

Brucks, Steffen; Little, William C.; Chao, Tania; Rideman, Ronald L; Upadhya, Bharathi; Wesley-Farrington, Deborah; Sane, David C.

doi:10.1016/j.amjcard.2003.12.062

Cited by 96 publications

(68 citation statements)

References 11 publications

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“…2B). This finding is consistent with Brucks et al, who found the same significant relationship (P < 0.0001) for BNP in diastolic heart failure [20]. We are unable to attribute these observations to BMI and age as there was no significant relationship between these parameters and Hgb in this group, and a multivariate analysis showed that log BNP remained independent.…”

Section: Discussionsupporting

confidence: 91%

Relationship of B‐type natriuretic peptide and anemia in patients with and without heart failure: A substudy from the Breathing Not Properly (BNP) Multinational Study

Omland

Knudsen

et al. 2005

American J Hematol

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While anemia is a significant risk factor for poor outcomes in patients with heart failure (HF), it is not in defined guidelines for HF assessment. B-type natriuretic peptide (BNP) is a marker for diagnosis and management of patients with HF. We determined the incidence of anemia in patients with HF and the relationship between BNP and hemoglobin (Hgb) levels in patients with and without HF. Results from the Breathing Not Properly Multinational Trial consisted of 1586 patients presenting to the emergency department (ED) with dyspnea. Because renal insufficiency is a confounding variable for BNP, patients with a creatinine of ‡2.0 mg/dL were excluded. The remaining data were evaluated from 620 non-HF patients (337 M, 283 F) and 547 HF patients (299 M, 248 F). The New York Heart Association (NYHA) HF classification and ejection fraction by echocardiography were assessed for HF patients. Blood was tested for Hgb, BNP, and creatinine. Using World Health Organization criteria for anemia, we observed that HF patients in NYHA class III or IV had lower mean Hgb levels (12.5 g/dL, P < 0.05) and a higher incidence of anemia (48.2%, P < 0.05) than did HF patients in class I or II (13.4 g/dL and 33.9%, respectively). There was no correlation between Hgb and log BNP for females without HF or the aggregate of all HF patients. In contrast, a significant inverse correlation was observed for males without HF (P < 0.001). Although there were differences in the BMI, age, and estimated glomerular filtration rate (eGFR) versus Hgb observed in this group, the log BNP correlation remained significant after multivariate analysis. A significant inverse correlation for log BNP and Hgb were also observed for diastolic (EF ‡ 50) HF (P < 0.05) that was also not accounted for by the BMI, age, or eGFR. The presence of anemia is associated with worsening HF at ED presentation. For males without HF and diastolic HF patients of both genders, a low Hgb may be a confounding variable toward

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Section: Discussionsupporting

confidence: 91%

Relationship of B‐type natriuretic peptide and anemia in patients with and without heart failure: A substudy from the Breathing Not Properly (BNP) Multinational Study

Omland

Knudsen

et al. 2005

American J Hematol

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“…Its prevalence is similar to that of CKD, diabetes, and COPD 229, 230, 231. Anemia is mostly prevalent in elderly women with advanced HFpEF, CKD, and diabetes 232, 233, 234.…”

Section: Comorbid Conditionsmentioning

confidence: 87%

Clinical Phenotypes in Heart Failure With Preserved Ejection Fraction

Samson

Jaiswal

Ennezat

et al. 2016

JAHA

109

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“…Previous studies have also shown that serum creatinine and the prevalence of anemia were higher in DHF patients than in hypertensive patients without heart failure (13), and anemia exacerbated the prognosis of DHF patients (32,33). Thus, renal insufficiency may increase the prevalence of DHF partly through the induction of anemia in hypertensive patients without reduced EF.…”

Section: Renal Insufficiency and Dhfmentioning

confidence: 97%

Difference of Clinical Characteristics between Hypertensive Patients with and without Diastolic Heart Failure: The Roles of Diastolic Dysfunction and Renal Insufficiency

et al. 2008

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Clinical characteristics were compared between hypertensive patients with and without heart failure in the absence of reduced ejection fraction (EF) to gain insights into the effects of renal insufficiency on the prevalence of diastolic heart failure. Study subjects consisted of 691 hypertensive patients with an EF >40%. Patients with serum creatinine >2.5 mg/dL were excluded from the study. The Framingham heart failure criteria were met by 198 patients, and competing risks of the prevalence of heart failure were analyzed. The multiple logistic regression analysis revealed that obesity, female gender, creatinine clearance (CCr), and a ratio of transmitral E velocity to early diastolic mitral annular velocity (E /E ′) >15 were independently associated with the prevalence of heart failure with preserved EF. Patients with 60≤ CCr <90 mL/min represented higher E /E ′ ratio and lower E ′ velocity than the patients with CCr≥90 mL/min, although there was no difference in the prevalence of heart failure between the two groups. These indices were not different between the patients with 60≤ CCr <90 mL/min and CCr <60 mL/min, although the prevalence of heart failure was higher in the patients with CCr <60 mL/min. The hemoglobin concentration was significantly decreased and the brachial-ankle pulse wave velocity was significantly elevated in patients with CCr <60 mL/min. Thus, progressive left ventricular diastolic dysfunction and renal insufficiency are competing risks of the prevalence of diastolic heart failure in hypertensive patients. Renal insufficiency may exert its effects through the modulation of extracardiac factors such as anemia and arterial stiffening rather than through the promotion of

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Relation of anemia to diastolic heart failure and the effect on outcome

Cited by 96 publications

References 11 publications

Relationship of B‐type natriuretic peptide and anemia in patients with and without heart failure: A substudy from the Breathing Not Properly (BNP) Multinational Study

Relationship of B‐type natriuretic peptide and anemia in patients with and without heart failure: A substudy from the Breathing Not Properly (BNP) Multinational Study

Clinical Phenotypes in Heart Failure With Preserved Ejection Fraction

Difference of Clinical Characteristics between Hypertensive Patients with and without Diastolic Heart Failure: The Roles of Diastolic Dysfunction and Renal Insufficiency

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