scholarly journals The prevalence and clinical significance of anemia in patients hospitalized with acute heart failure

F1000Research ◽  
2017 ◽  
Vol 5 ◽  
pp. 1006
Author(s):  
Attila Frigy ◽  
Zoltán Fogarasi ◽  
Ildikó Kocsis ◽  
Lehel Máthé ◽  
Előd Nagy
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Clinical Laboratory ◽  
Renal Perfusion ◽  
Multiple Regression Model ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
High Dose ◽  
Ventricular Ejection Fraction ◽  
Prevalence Of Anemia

Abstract: In a cohort of patients hospitalized with acute heart failure (AHF) the prevalence of anemia and the existence of a correlation between anemia and the severity of the clinical picture were assessed. Methods: 50 consecutive patients (34 men, 16 women, mean age 67.5 years) hospitalized with AHF were enrolled.  Statistical analysis was performed for studying correlations between anemia and the presence/levels of diverse parameters (clinical, laboratory, echocardiographic, treatment related)  reflecting the severity and prognosis of AHF (α=0.05). Results: 21 patients (14 men, 7 women, mean age 69.6 years), representing 42%, had anemia  at admission. Comparing patients with and without anemia there were no significant differences regarding age,  gender,  presence of atrial fibrillation (p=0.75), diabetes (p=1), ischemic heart disease (p=0.9), left ventricular ejection fraction (EF) (p=1), hypotension (p=0.34) and tachycardia>100 b/min at admission (p=0.75), level of eGFR (p=0.72), and need of high dose (>80 mg/day)  loop diuretic (p=0.23). However, EF showed a significant positive correlation with eGFR only in AHF patients with anemia (r=0,65, p=0.001). In a multiple regression model, EF had a significant effect on the eGFR quartiles (p=0,004). Conclusions: Anemia is a frequent finding in patients hospitalized with AHF. The presence of anemia was not correlated with other factors related to AHF severity and prognosis. However, a low EF associated with low eGFR was characteristic for patients with anemia, suggesting that the decrease of renal perfusion by low cardiac output further aggravates anemia on the background of chronic kidney disease.

scholarly journals NT-proBNP and Echocardiographic Parameters in Patients with Acute Heart Failure

2007 ◽  
Vol 50 (1) ◽  
pp. 51-56 ◽  
Author(s):  
Radek Pudil ◽  
Miloš Tichý ◽  
Rudolf Praus ◽  
Václav Bláha ◽  
Jan Vojáček
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Acute Heart Failure ◽  
Vena Cava ◽  
Left Ventricular ◽  
Clinical Severity ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
X Ray ◽  
Cardiothoracic Ratio

Aim. The aim of this study was to analyse the relation between clinical, haemodynamic and X-ray parameters and plasma NT-proBNP level in pts with symptoms of left ventricular dysfunction. Methods. The plasma NT-proBNP levels, chest x-ray, transthoracic 2-d and Doppler echocardiography were performed at the time of admission in a group of 96 consecutive patients (mean age 68 ± 11 years) with symptoms of acute heart failure. NT-proBNP levels were assessed with the use of commercial tests (Roche Diagnostics). Results. All patients have significant increase in NT-proBNP (8 000 ± 9 000 pg/mL vs. controls 90 ± 80 pg/mL, p < 0.001). The group of all patients has shown a significant increase in cardiothoracic ratio (CTR, 0.6 ± 0.1, vs. 0.4 ± 0.1, p <0.001), left atrium diameter (LAD, 4.4 ± 0.8 cm, vs.3.5 ± 0.4 cm, p <0.01). Left ventricular ejection fraction (LVEF) was decreased (37 ± 15%, vs. 64 ± 5%, p <0.001). In patients with acute heart failure, NT-proBNP significantly correlated with end-systolic and end-diastolic left ventricle diameters, ejection fraction, vena cava inferior diameter and plasma creatinine levels. Conclusion. Increased plasma NT-proBNP level is influenced by the clinical severity of acute heart failure and correlates with LVEF and IVCD. NT-proBNP can serve as a marker for the clinical severity of the disease.

scholarly journals Prognostic Significance of Serum Cysteine-Rich Protein 61 in Patients with Acute Heart Failure

2018 ◽  
Vol 48 (3) ◽  
pp. 1177-1187 ◽  
Author(s):  
Jingjing Zhao ◽  
Chongyu Zhang ◽  
Jian Liu ◽  
Lili Zhang ◽  
Yalin Cao ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Acute Heart Failure ◽  
Prognostic Significance ◽  
Left Ventricular ◽  
Curve Analysis ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Cysteine Rich Protein ◽  
Kaplan Meier

Background/Aims: Cyr61-cysteine-rich protein 61 (CCN1/CYR61) is a multifunctional matricellular protein involved in the regulation of fibrogenesis. Animal experiments have demonstrated that CCN1 can inhibit cardiac fibrosis in cardiac hypertrophy. However, no study has been conducted to assess the relation between serum CCN1 and prognosis of acute heart failure (AHF). Methods: We measured the serum CCN1 levels of 183 patients with AHF, and the patients were followed up for 6 months. The associations between CCN1 levels and some clinical covariates, especially left ventricular ejection fraction (LVEF), estimated glomerular filtration rate (eGFR), atrial fibrillation and age, were estimated. The AHF patients were followed up for 6 months. The endpoint was all-cause mortality. Kaplan-Meier curve analysis and multivariable Cox proportional hazards analysis were employed to evaluate the prognostic ability of CCN1. We used calibration, discrimination and reclassification to assess the mortality risk prediction of adding CCN1. Results: Serum CCN1 concentrations in AHF patients were significantly increased compared with those in individuals without AHF (237 pg/ml vs. 124.8 pg/ml, p< 0.001). CCN1 level was associated with the level of NT-proBNP (r=0.349, p< 0.001) and was not affected by LVEF, eGFR, age or atrial fibrillation in AHF patients. Importantly, Kaplan-Meier curve analysis illustrated that the AHF patients with serum CCN1 level > 260 pg/ ml had a lower survival rate (p< 0.001). Multivariate Cox hazard analysis suggests that CCN1 functions as an independent predictor of mortality for AHF patients (LgCCN1, hazard ratio 5.825, 95% confidence interval: 1.828-18.566, p=0.003). In addition, the inclusion of CCN1 in the model with NT-proBNP significantly improved the C-statistic for predicting death (0.758, p< 0.001). The integrated discrimination index was 0.019 (p< 0.001), and the net reclassification index increased significantly after addition of CCN1 (23.9%, p=0.0179). Conclusions: CCN1 is strongly predictive of 6-month mortality in patients with AHF, suggesting serum CCN1 as a promising candidate prognostic biomarker for AHF patients.

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