Kılıçgedik Alev, Dündar Cihan, Tigen Mustafa Kürşat
Clinic of Cardiology, Kocaeli State Hospital, Kocaeli-Turkey.
Anadolu Kardiyol Derg. 2012 Feb;12(1):65-70. doi: 10.5152/akd.2012.011. Epub 2012 Jan 4.
Chronic heart failure is a common problem and a major cause of death, hospital admission, poor physical function and impaired quality of life. In addition to the direct effect of heart failure on prognosis, several modifiable and non-modifiable factors contribute to the worse prognosis in heart failure. Anemia, which is common in patients with heart failure, may represent a modifiable risk factor for adverse outcome. It is also a marker for co-morbidity burden and greater disease severity. If anemia is a marker, treatment may not obviate the increased risk associated with anemia, but if it is a mediator, treatment may be helpful to reduce morbidity and mortality in heart failure. As anemia has been identified as an independent prognostic factor of both morbidity and mortality for patients with congestive heart failure, there is an increased interest in the hypothesis that the correction of anemia with erythropoietin or iron supplementation might lead to an improvement on patients' symptoms and functional status. Large randomized trials are necessary to show the effect of anemia and the specific treatments on the outcome in these patients. This article reviews the mechanisms, impact on outcomes and therapy of anemia in patients with heart failure.
慢性心力衰竭是一个常见问题，也是导致死亡、住院、身体功能不佳和生活质量受损的主要原因。除了心力衰竭对预后的直接影响外，一些可改变和不可改变的因素也会导致心力衰竭患者预后更差。贫血在心力衰竭患者中很常见，可能是不良结局的一个可改变风险因素。它也是合并症负担和疾病严重程度更高的一个标志。如果贫血是一个标志，治疗可能无法消除与贫血相关的增加风险，但如果它是一个介导因素，治疗可能有助于降低心力衰竭的发病率和死亡率。由于贫血已被确定为充血性心力衰竭患者发病和死亡的独立预后因素，人们对用促红细胞生成素或补充铁剂纠正贫血可能改善患者症状和功能状态这一假设的兴趣日益增加。需要进行大型随机试验来证明贫血及特定治疗对这些患者结局的影响。本文综述了心力衰竭患者贫血的机制、对结局的影响及治疗方法。
