The relation between serum erythropoietin level and severity of disease and mortality in patients with chronic heart failure.
OBJECTIVE
We evaluated the relation between serum erithropoietin level and the severity of disease and mortality in patients with chronic heart failure (CHF).


METHODS
We enrolled 96 CHF patients and 50 age- and sex-matched control subjects. Haemoglobin, haemotocrit, N terminal pro-B type natriuretic peptide (NT-proBNP) and erythropoietin levels and echocardiographic parameters were measured. The patients were contacted 1 year after the evaluations to determine survival.


RESULTS
The patients had lower haemoglobin and haematocrit but higher serum erythropoietin and NT-proBNP levels than the control subjects. Serum erythropoietin and NT-proBNP levels increased with worsening functional class. The serum erythropoietin level correlated negatively with left ventricular ejection fraction (r = -0.404, P < 0.001), haemoglobin (r = -0.530, P < 0.001) and haematocrit (r = -0.496, P < 0.001) levels. The patients who died (n = 17) had lower haemoglobin and haematocrit levels and significantly higher erythropoietin and NT-proBNP levels. However, multivariate logistic regression analysis showed that only NT-proBNP level was an independent predictor of mortality (P = 0.002).


CONCLUSIONS
Anaemia and resistance to erythropoietin develop proportionately to disease severity and left ventricular systolic dysfunction in patients with CHF. Although serum erythropoietin level seems related with mortality, this observation needs to be confirmed by studies with more patients and longer follow-up.
Avkaroğullari
Mahir
M
Cukurova University, School of Medicine, Department of Cardiology, Adana, Turkey.
Bozkurt
Abdi
A
Akpinar
Onur
O
Dönmez
Yurdaer
Y
Demirtaş
Mustafa
M
D015415:Biomarkers / Q000097:blood; D002908:Chronic Disease; D004452:Echocardiography; D004921:Erythropoietin / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis / Q000401:mortality*; D006400:Hematocrit; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011379:Prognosis; D011498:Protein Precursors; D012720:Severity of Illness Index; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014421:Turkey / Q000453:epidemiology
D015415:Biomarkers; D010446:Peptide Fragments; D011498:Protein Precursors; C109794:pro-brain natriuretic peptide (1-76); D004921:Erythropoietin; D020097:Natriuretic Peptide, Brain