Renal dysfunction and anemia in patients with heart failure with reduced versus normal ejection fraction.
BACKGROUND
The presence of anemia and renal dysfunction grants a bad prognosis for patients with heart failure and reduced ejection fraction (HFREF). The impact on patients with heart failure and normal ejection fraction (HFNEF) is not widely studied.


OBJECTIVE
To study the prevalence and the prognosis of anemia and renal dysfunction (RD) in patients with heart failure according to the type of ventricular dysfunction.


METHODS
A total of 209 patients with chronic and stable heart failure were prospectively studied. Individuals with ejection fraction <50% were considered as HFREF patients. Anemia was defined, based on WHO criteria, as hemoglobin <13 g/dl for men and <12 g/dl for women. Renal function was calculated by means of the Simplified Modified Diet Renal Disease (sMDRD) formula. Hospitalizations, emergency admittances and obit by cardiac causes were considered as cardiac events.


RESULTS
Ninety patients had HFREF and 119 had HFNEF. The glomerular filtration rate (GFR) was smaller in HFREF group (57.6 +/- 66.2 versus 94.8 +/- 36.6 ml/min/1.73m(2); p=0.01). There was no difference in the prevalence of anemia between groups (23.3% versus 18.5%; p=0.34). Moderate to severe RD prevalence was higher in HFREF group (32.2% versus 16.8%; p=0.01). RD was the only factor associated with anemia that was independently associated with cardiac events (HR 2.52; 95%CI=1.27-5.2; p=0.01).


CONCLUSIONS
RD was less prevalent in HFNEF, while the prevalence of anemia did not differ between groups. RD was predictor of cardiac events independently on ejection fraction.
Villacorta
Humberto
H
Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, RJ, Brasil.
Saenz-Tello
Bolivar F
BF
Santos
Eduarda Barcellos dos
EB
Steffen
Ricardo
R
Wiefels
Christiane
C
Lima
Luiz Costa
LC
Sales
Ana Luíza F
AL
Soares
Pedro
P
Mesquita
Evandro Tinoco
ET
D000368:Aged; D000740:Anemia / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D001938:Brazil / Q000453:epidemiology; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D051437:Renal Insufficiency / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D012737:Sex Factors; D013318:Stroke Volume / Q000502:physiology*