Abstract
Anaemia is a common comorbidity in patients with heart failure (HF) and is associated with more severe symptoms and increased mortality. The aim of this study was to evaluate haemodynamic profiles of HF patients with respect to the presence of reduced left ventricular ejection fraction (LVEF) and anaemia. Methods and Results. Haemodynamic status was evaluated in 97 patients with acute decompensated HF. Impedance cardiography, echocardiography, and N-terminal probrain natriuretic peptide (NT-proBNP) results were analysed. The study group was stratified into four subgroups according to LVEF (<40% vs ≥40%) and the presence of anaemia (haemoglobin <13.0 g/dL in men and <12.0 g/dL in women). Thoracic fluid content was higher (p=0.037) in anaemic subjects, while no significant relation between anaemia and NYHA was observed. Anaemic subjects with LVEF ≥ 40% were distinguished from those with LVEF < 40% by significantly higher stroke index (p=0.002), Heather index (p=0.014), and acceleration index (p=0.047). Patients with reduced LVEF and anaemia presented the highest NT-proBNP (p=0.003). Conclusions. In acute decompensated HF, anaemia is related with fluid overload, relatively higher cardiac systolic performance but no clinical benefit in patients with preserved/midrange LVEF, and increased left ventricular tension, fluid overload, and impaired cardiac systolic performance in patients with reduced LVEF.
Highlights
Anaemia is a common comorbidity in patients with heart failure (HF) and is associated with increased symptom severity and higher mortality [1, 2]
E haemodynamic response to tissue hypoxia induced by severe anaemia in patients without cardiac disease presents as tachycardia, high cardiac output induced by the activation of the sympathetic nervous system, low vascular resistance caused by generalised vasodilation, and fluid retention [3,4,5]
Study Population. is retrospective secondary analysis included data of 97 patients who were enrolled to the prospective observational study. is study aimed to evaluate the complex pathophysiological background related to HF deterioration with respect to the in-hospital treatment received. e data on the usefulness of noninvasive haemodynamic assessment in admission diagnostics and monitoring of the effects of treatment in patients hospitalised due to acute decompensated HF (ADHF) have been previously published [9]
Summary
Anaemia is a common comorbidity in patients with heart failure (HF) and is associated with increased symptom severity and higher mortality [1, 2]. E haemodynamic response to tissue hypoxia induced by severe anaemia in patients without cardiac disease presents as tachycardia, high cardiac output induced by the activation of the sympathetic nervous system, low vascular resistance caused by generalised vasodilation, and fluid retention [3,4,5]. In extreme cases, it can manifest as “noncardiac circulatory congestion” with pulmonary oedema and hypotension [3, 5]. Anaemia-related haemodynamic and neurohormonal alterations could potentially result in reduced systolic function related to impaired Frank–Starling responses to preload, in failing hearts [7]
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