title: The impact of anaemia and kidney function in congestive heart failure and preserved systolic function.
abstract: BACKGROUND
  The importance of anaemia in chronic heart failure was highlighted recently by different cohort studies. The aim of this study was to assess the prevalence of anaemia and its relationship to renal function, left ventricular function and symptoms of heart failure.
  
  
  METHODS
  We surveyed cases of patients admitted to the Department of Cardiology during 22 consecutive months. Laboratory measurements, blood pressure and echocardiographic parameters were obtained with standardized methods.
  
  
  RESULTS
  Out of a total number of 2941 patients, 238 patients (8.1%) had haemoglobin values <11 g/dl. There was a positive association of anaemia with the symptoms of heart failure with a lowering of the median haemoglobin from 14.2 g/dl [New York Heart Association (NYHA) I] to 12.9 g/dl (NYHA IV, P<0.001). Interestingly, anaemia was not associated with left ventricular function or any left ventricular parameters. Symptoms of heart failure, however, were associated with kidney function. The estimated glomerular filtration rate (GFR) was 82 ml/min at NYHA I and 59 ml/min at NYHA IV, P<0.05. There was an association between impaired renal function and haemoglobin values. Haemoglobin was 14.2 g/dl in the group with normal renal function and 11.1 g/dl in the group with a GFR <25 ml/min (P<0.001). Even in patients with normal renal function (878 patients, GFR >85 ml/min), we still found an association of anaemia with the symptoms of heart failure. Haemoglobin was 14.5 g/dl at NYHA I and 13.4 g/dl at NYHA IV, P<0.0001.
  
  
  CONCLUSIONS
  Anaemia is found in 8.1% of patients admitted to cardiology service. Anaemia was clearly associated with symptoms of congestive heart failure even in patients with normal renal function. Anaemia was not associated with left ventricular function.
authors.affiliation: Department of Cardiology, Campus Buch and Virchow, Charité, Humboldt University, Berlin, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Philipp
authors.forename: Henrike
authors.initials: H
authors.lastname: Ollmann
authors.forename: Tania
authors.initials: T
authors.lastname: Schink
authors.forename: Rainer
authors.initials: R
authors.lastname: Dietz
authors.forename: Friedrich C
authors.initials: FC
authors.lastname: Luft
authors.forename: Roland
authors.initials: R
authors.lastname: Willenbrock
mesh_terms: D000368:Aged; D000740:Anemia / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000097:blood* / Q000503:physiopathology*; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D013599:Systole; D016277:Ventricular Function, Left