Pappas Konstantinos D, Gouva Chariklia D, Katopodis Konstantinos P, Nikolopoulos Petros M, Korantzopoulos Panagiotis G, Michalis Lampros K, Goudevenos John A, Siamopoulos Kostas C
Department of Cardiology, Medical School, University of Ioannina, 45110, Ioannina, Greece.
Cardiovasc Drugs Ther. 2008 Feb;22(1):37-44. doi: 10.1007/s10557-007-6075-6. Epub 2007 Dec 20.
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.
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.
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.
Correction of anemia with rhuEpo in patients with CKD seems to improve cardiac performance and geometry.
慢性肾脏病（CKD）患者使用促红细胞生成素（rhuEpo）纠正贫血对心脏功能和结构是否有益尚不清楚。大多数研究基于收缩功能指标和左心室质量（LVM），结果相互矛盾。
我们试图使用传统和新型超声心动图指标研究rhuEpo对左心室收缩和舒张功能的影响。纳入31例CKD患者（3期或4期）。15例患者（I组）接受rhuEpo治疗，目标血红蛋白水平≥13.0 g/dL，其余患者（II组）未接受治疗。在基线和1年后记录临床和实验室参数。仔细测定射血分数（EF）和LVM。通过二尖瓣血流指标（E和A波速度、Edt减速时间和E/A）以及使用组织多普勒成像的二尖瓣环运动新型指标（Em、Am和E/Em）评估舒张功能。还计算了整体心脏功能指标（Tei）。
基线时，两组患者的临床和实验室特征具有可比性。1年后，与II组患者相比，I组患者的血红蛋白水平（13.6±1.2 vs 10.3±1.2 g/dL，p<0.05）以及收缩和舒张功能指标均有显著改善：EF（70.5±7.6 vs 63.4±9.3%，p<0.05）、LVM（116.5±34.9 vs 155.6±51.6 g/m²，p<0.05）；Edt（233.9±98.6 vs 166.9±45.1 ms，p<0.05）、Tei指数（0.35±0.12 vs 0.51±0.17，p<0.01）和E/Em（9.7±2.4 vs 14.8±5.2，p<0.05）。血压和心率无显著变化。
CKD患者使用rhuEpo纠正贫血似乎可改善心脏功能和结构。
