108 Importance of haemodilution in haemoglobin concentrations in outpatients with chronic heart failure. Results of IMPACT-RECO Program III

Abstract

The prevalence of anaemia in chronic heart failure (CHF) ranges widely from 4 to 70% due to a lack of an established consistent definition of anaemia in CHF. Furthermore haemodilution impacts haemoglobin concentrations and could be an important cause of anaemia in CHF. The IMPACT-RECO program III analysed the impact of NYHA class of CHF and of comorbidities on therapeutic management of French outpatients with stable CHF and left ventricular systolic dysfunction. This survey was carried out from March 2007 to December 2007 among randomly selected French private cardiologists. 1574 patients with CHF and left ventricular ejection fraction (LVEF) < 40% were included. Mean age was 71 ± 11 years, 75% of the patients were men, 34% were in NYHA class III-IV, 54% had coronary artery diseases, 30% had atrial fibrillation and the mean LVEF was 34 ± 7%. Haemoglobin concentration was recorded in 953 patients. Anemia was defined as a haemoglobin concentration < 12 g/L in women and < 13 g/L in men. The impact of NYHA class and congestive status in haemoglobin concentrations are summarized in the table. Congestive status impacts haemoglobin concentrations more than the severity of CHF estimated by NYHA class. Haemodilution is an important aetiology of anaemia in CHF, thus haemoglobin concentration should be evaluated if possible in patients without congestive signs. Haemoglobin (g/L) NYHA I NYHA II without congestive signs NYHA II with congestive signs NYHA III NYHA IV n 107 448 62 295 37 Men 13.3 ± 1.6 13.4 ± 1.7 12.1 ± 1.9 12.7 ± 1.8 13.4 ± 1.6 Women 12.7 ± 1.2 12.6 ± 1.3 11.8 ± 2.5 12.1 ± 1.6 12.2 ± 2.1 Anaemia N (%) 33 (30.8) 150 (33.5) 42 (67.7) ** 149 (50.5) * 15 (40.5) * p < 0.05: NYHA III vs NYHA I,II / ** p < 0.05 : NYHA II with congestive signs vs NYHA I,II without congestive signs III,IV.