Anemia management in heart failure: a thick review of thin data.
Heart failure is defined as the inability of the heart to pump blood at an amount sufficient to meet the metabolic needs of the body. In heart failure, the inability to meet the body's metabolic needs is based on hemodynamic derangement and suboptimal oxygen-carrying capacity of the blood itself. Current pharmacologic therapy attempts to improve survival and reduce symptomatology by optimizing hemodynamics to increase oxygen delivery, but does not address oxygen-carrying capacity. Unfortunately, there is a high prevalence of anemia in patients with heart failure, which compromises oxygen-carrying capacity, is an independent predictor of mortality, and may be caused in part by pharmacologic agents that confer morbidity and mortality benefits in this population. Recombinant human erythropoietin supplementation improves the functional capacity of the failing myocardium, reverses and antagonizes the detrimental remodeling induced by autoimmune activity, and may reduce mortality and morbidity among patients receiving maximal pharmacologic therapy for heart failure. However, limited clinical data prohibit widespread recommendations for its use in patients with heart failure.
McBride
Brian F
BF
Hartford Hospital Drug Information Center, Hartford, Connecticut 06102-5037, USA.
White
C Michael
CM
D000740:Anemia / Q000188:drug therapy* / Q000209:etiology*; D001809:Blood Viscosity / Q000187:drug effects; D004921:Erythropoietin / Q000494:pharmacology / Q000627:therapeutic use*; D006333:Heart Failure / Q000188:drug therapy / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D016019:Survival Analysis
D004921:Erythropoietin