Anemia‐declined Functional Capacity Is Associated with Impaired Erythrocyte Rheological Function in Patients with Heart Failure

Abstract

Anemia is a common co‐morbidity in patients in heart failure (HF), which develops further deconditioning and consequently vicious cycle of cardiovascular disorders. Whether anemia influences the rheological characteristics and leads to exercise intolerance in the HF patients remains unclear. This study investigated the relationship between erythrocyte rheological functions and function capacity in the HF patients with anemia. According to the WHO criteria, eighty‐eight CHF patients were divided into normal (N‐A, n=47), light anemic (L‐A, n=21), and moderate‐several anemic (MS‐An, n=20) groups. Our results revealed that the MS‐An group had (i) smaller VO2peak and oxygen uptake efficiency slope and greater VE‐VO2 slope, (ii) higher levels of senescent (CD47−) and immature (CD71+) erythrocytes in blood, (iii) less the ability to tolerance of erythrocytes to osmotic stress, (iv) larger erythrocyte aggregability that was accompanied by elevated blood viscosity, and (v) lower the degree of erythrocyte deformation caused by shear stress, compared to those of both N‐A and L‐A groups. Moreover, the extents of impaired erythrocyte rheological functions were associated with the decline of aerobic capacity in the HF patients. We conclude that anemia limits the delivery of oxygen to tissues by impairing erythrocyte rheological function, thereby reducing functional capacity in patients with HF.