title: Effects of blood transfusion on exercise capacity in thalassemia major patients.
abstract: Anemia has an important role in exercise performance. However, the direct link between rapid changes of hemoglobin and exercise performance is still unknown.To find out more on this topic, we studied 18 beta-thalassemia major patients free of relevant cardiac dysfunction (age 33.5±7.2 years,males = 10). Patients performed a maximal cardiopulmolmonary exercise test (cycloergometer, personalized ramp protocol, breath-by-breath measurements of expired gases) before and the day after blood transfusion (500 cc of red cell concentrates). After blood transfusion, hemoglobin increased from 10.5±0.8 g/dL to 12.1±1.2 (p<0.001), peak VO2 from 1408 to 1546mL/min (p<0.05), and VO2 at anaerobic threshold from 965 to 1024mL/min (p<0.05). No major changes were observed as regards heart and respiratory rates either at peak exercise or at anaerobic threshold. Similarly, no relevant changes were observed in ventilation efficiency, as evaluated by the ventilation vs. carbon dioxide production relationship, or in O2 delivery to the periphery as analyzed by the VO2 vs. workload relationship. The relationship between hemoglobin and VO2 changes showed, for each g/dL of hemoglobin increase, a VO2 increase = 82.5 mL/min and 35 mL/min, at peak exercise and at anaerobic threshold, respectively. In beta-thalassemia major patients, an acute albeit partial anemia correction by blood transfusion determinates a relevant increase of exercise performance, observed both at peak exercise and at anaerobic threshold.
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milano, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Benedetto
authors.affiliation: Azienda Bianchi Melacrino Morelli, Cardiology Department, Reggio di Calabria, Italy.
authors.forename: Carmelo Massimo
authors.initials: CM
authors.lastname: Rao
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milano, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Cefalù
authors.affiliation: Azienda Bianchi Melacrino Morelli, Cardiology Department, Reggio di Calabria, Italy.
authors.forename: Demetrio Oreste
authors.initials: DO
authors.lastname: Aguglia
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milano, Italy.
authors.forename: Gaia
authors.initials: G
authors.lastname: Cattadori
authors.affiliation: Azienda Bianchi Melacrino Morelli, Hematology Department, Reggio di Calabria, Italy.
authors.forename: Domenico Giuseppe
authors.initials: DG
authors.lastname: D'Ascola
authors.affiliation: Azienda Bianchi Melacrino Morelli, Cardiology Department, Reggio di Calabria, Italy.
authors.forename: Frank Antonio
authors.initials: FA
authors.lastname: Benedetto
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milano, Italy; Dipartimento di Scienze Cliniche e di Comunità, Sezione cardiovascolare, Università di Milano, Milano, Italy.
authors.forename: Piergiuseppe
authors.initials: P
authors.lastname: Agostoni
authors.affiliation: Dipartimento di Scienze Cardiovascolari e Respiratorie, Università "Sapienza", Roma, Italy.
authors.forename: Susanna
authors.initials: S
authors.lastname: Sciomer
mesh_terms: D000328:Adult; D015308:Anaerobic Threshold; D001803:Blood Transfusion; D015444:Exercise; D005260:Female; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D008297:Male; D010100:Oxygen / Q000097:blood*; D017086:beta-Thalassemia / Q000097:blood / Q000503:physiopathology / Q000628:therapy
chemical_list: D006454:Hemoglobins; D010100:Oxygen