Sezai Akira, Sekino Hisakuni, Taoka Makoto, Osaka Shunji, Tanaka Masashi
Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo 173-8610, Japan.
Sekino Hospital, Tokyo 171-0014, Japan.
Biomedicines. 2023 Mar 20;11(3):946. doi: 10.3390/biomedicines11030946.
Erythropoiesis-stimulating agents improve the NYHA functional class and decrease the hospital readmission rates for heart failure; however, little is known about the influence of continuous erythropoietin receptor activator (CERA) on the heart. Therefore, a prospective study was conducted to investigate the effects of CERA on cardiac and renal function and oxidative stress in chronic heart failure with renal anemia. Sixty patients with chronic heart failure and renal anemia were enrolled and received CERA for 12 months. The primary endpoints were hemoglobin (Hb) and hematocrit, and the secondary endpoints were: (1) atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP); (2) NYHA class; (3) echocardiography; (4) blood urea nitrogen, creatinine, cystatin C, and urinary albumin; (5) high-sensitivity C-reactive protein; (6) oxidized low-density lipoprotein (Ox-LDL); and (7) renin, angiotensin-II, and aldosterone. There was a significant difference in the Hb levels measured before and after CERA administration. The BNP, ANP, NYHA, left ventricular mass index, renal function, and Ox-LDL decreased significantly after CERA administration. This study shows that CERA improves anemia and reduces renal impairment, as well as cardiac and oxidative stress. The result of this study is useful for a study in which switching from CERA to a new renal anemia drug, hypoxia-inducible factor prolyl-hydroxylase inhibitor, is investigated.
促红细胞生成素能改善纽约心脏协会（NYHA）心功能分级，并降低心力衰竭患者的再入院率；然而，关于持续促红细胞生成素受体激活剂（CERA）对心脏的影响却知之甚少。因此，开展了一项前瞻性研究，以探讨CERA对合并肾性贫血的慢性心力衰竭患者心脏和肾脏功能以及氧化应激的影响。60例合并慢性心力衰竭和肾性贫血的患者入组并接受CERA治疗12个月。主要终点为血红蛋白（Hb）和血细胞比容，次要终点包括：（1）心房利钠肽（ANP）和B型利钠肽（BNP）；（2）NYHA分级；（3）超声心动图；（4）血尿素氮、肌酐、胱抑素C和尿白蛋白；（5）高敏C反应蛋白；（6）氧化型低密度脂蛋白（Ox-LDL）；（7）肾素、血管紧张素II和醛固酮。CERA给药前后测得的Hb水平存在显著差异。CERA给药后，BNP、ANP、NYHA分级、左心室质量指数、肾功能和Ox-LDL均显著降低。本研究表明，CERA可改善贫血，减轻肾脏损害以及心脏和氧化应激。本研究结果对于一项探讨从CERA转换为新型肾性贫血药物——缺氧诱导因子脯氨酰羟化酶抑制剂的研究具有参考价值。
