Heart failure and anemia: Effects on prognostic variables.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Cattadori Gaia, Agostoni Piergiuseppe, Corrà Ugo, Sinagra Gianfranco, Veglia Fabrizio, Salvioni Elisabetta, Bonomi Alice, La Gioia Rocco, Scardovi Angela B, Ferraironi Alessandro, Emdin Michele, Metra Marco, Di Lenarda Andrea, Limongelli Giuseppe, Raimondo Rosa, Re Federica, Guazzi Marco, Belardinelli Romualdo, Parati Gianfranco, Caravita Sergio, Magrì Damiano, Lombardi Carlo, Frigerio Maria, Oliva Fabrizio, Girola Davide, Mezzani Alessandro, Farina Stefania, Mapelli Massimo, Scrutinio Domenico, Pacileo Giuseppe, Apostolo Anna, Iorio AnnaMaria, Paolillo Stefania, Filardi Pasquale Perrone, Gargiulo Paola, Bussotti Maurizio, Marchese Giovanni, Correale Michele, Badagliacca Roberto, Sciomer Susanna, Palermo Pietro, Contini Mauro, Giannuzzi Pantaleo, Battaia Elisa, Cicoira Mariantonietta, Clemenza Francesco, Minà Chiara, Binno Simone, Passino Claudio, Piepoli Massimo F, MECKI score Research Group (appendix)
Аннотация
METHODS: Clinical, laboratory, echocardiographic and cardiopulmonary-exercise-test (CPET) data were analyzed in 3913 HF patients grouped according to hemoglobin (Hb) values. 248 (6%), 857 (22%), 2160 (55%) and 648 (17%) patients had very low (<11g/dL), low (11-12 for females, 11-13 for males), normal (12-15 for females, 13-15 for males) and high (>15) Hb, respectively.
RESULTS: Median follow-up was 1363days (606-1883). CPETs were always performed safely. Hb was related to prognosis (Hazard ratio (HR)=0.864). No prognostic difference was observed between normal and high Hb groups. Peak oxygen consumption (VO2), ventilatory efficiency (VE/VCO2 slope), plasma sodium concentration, ejection fraction (LVEF), kidney function and Hb were independently related to prognosis in the entire population. Considering Hb groups separately, peakVO2 (very low Hb HR=0.549, low Hb HR=0.613, normal Hb HR=0.618, high Hb HR=0.542) and LVEF (very low Hb HR=0.49, low Hb HR=0.692, normal Hb HR=0.697, high Hb HR=0.694) maintained their prognostic roles. High VE/VCO2 slope was associated with poor prognosis only in patients with low and normal Hb.
CONCLUSIONS: Anemic HF patients have a worse prognosis, but CPET can be safely performed. PeakVO2 and LVEF, but not VE/VCO2 slope, maintain their prognostic power also in HF patients with Hb<11g/dL, suggesting CPET use and a multiparametric approach in HF patients with low Hb. However, the prognostic effect of an anemia-oriented follow-up is unknown.