Document Detail


Correction of anemia with erythropoietin in chronic kidney disease (stage 3 or 4): effects on cardiac performance.
MedLine Citation:
PMID:  18095148     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: It is not clear whether the correction of anemia with erythropoietin (rhuEpo) in patients with chronic kidney disease (CKD) has any benefit on cardiac function and geometry. Most studies are based on indices of systolic function and left ventricular mass (LVM) and the results are conflicting. PATIENTS AND METHODS: We sought to investigate the effect of rhuEpo on LV systolic and diastolic performance using conventional and novel echocardiographic indices. Thirty one patients with CKD (stage 3 or 4) were included. Fifteen patients (group I) treated with rhuEpo targeting at Hb >or=13.0 g/dL, while the remaining (group II) were not treated. Clinical and laboratory parameters were recorded at baseline and 1 year later. Ejection fraction (EF) and LVM were carefully determined. Diastolic function was assessed by mitral inflow indices (E and A wave velocities, Edt deceleration time and E/A) and novel indices of mitral annulus motion using Tissue Doppler Imaging (Em, Am, and E/Em). An index of global cardiac function (Tei) was also calculated. RESULTS: At baseline, the 2 groups had comparable clinical and laboratory characteristics. After 1 year, a significant improvement in Hb levels (13.6 +/- 1.2 vs 10.3 +/- 1.2 g/dL, p < 0.05) as well as in systolic and diastolic function indexes was observed in group I compared to group II patients: EF (70.5 +/- 7.6 vs 63.4 +/- 9.3%, p < 0.05), LVM (116.5 +/- 34.9 vs 155.6 +/- 51.6 g/m(2), p < 0.05), Edt (233.9 +/- 98.6 vs 166.9 +/- 45.1 ms, p < 0.05), Tei index (0.35 +/- 0.12 vs 0.51 +/- 0.17, p < 0.01) and E/Em (9.7 +/- 2.4 vs 14.8 +/- 5.2, p < 0.05), respectively. Blood pressure and heart rate did not show significant changes. CONCLUSIONS: Correction of anemia with rhuEpo in patients with CKD seems to improve cardiac performance and geometry.
Authors:
Konstantinos D Pappas; Chariklia D Gouva; Konstantinos P Katopodis; Petros M Nikolopoulos; Panagiotis G Korantzopoulos; Lampros K Michalis; John A Goudevenos; Kostas C Siamopoulos
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2007-12-20
Journal Detail:
Title:  Cardiovascular drugs and therapy / sponsored by the International Society of Cardiovascular Pharmacotherapy     Volume:  22     ISSN:  1573-7241     ISO Abbreviation:  Cardiovasc Drugs Ther     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-02-13     Completed Date:  2009-03-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8712220     Medline TA:  Cardiovasc Drugs Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  37-44     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Medical School, University of Ioannina, 45110, Ioannina, Greece.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Anemia / drug therapy*,  etiology
Blood Pressure / drug effects
Echocardiography, Doppler
Erythropoietin, Recombinant / pharmacology*,  therapeutic use
Female
Follow-Up Studies
Heart Rate / drug effects
Hematinics / pharmacology*,  therapeutic use
Humans
Kidney Failure, Chronic / complications,  drug therapy*
Male
Middle Aged
Prospective Studies
Ventricular Function, Left / drug effects
Chemical
Reg. No./Substance:
0/Erythropoietin, Recombinant; 0/Hematinics
Comments/Corrections
Comment In:
Cardiovasc Drugs Ther. 2008 Feb;22(1):1-2   [PMID:  18219567 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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