Chronic heart failure (HF) is a major public health concern,
which has reached epidemic dimensions. Current management strategies
aim primarily at blocking neurohormonal pathways that are pathologically
hyperactive. Despite the introduction of
pharmaceuticals that primarily cause
neurohormonal blockade, the morbidity
and mortality associated with chronic
HF remain unacceptably high, suggesting that this therapeutic approach has
reached its maximum benefit. Consequently, the identification of modifiable
risk factors which contribute to the poor
results of current medical therapy, and
the development of new treatments and
preventive measures, are keys to an
improvement in the management of
chronic HF.
Anemia is common and is a powerful
independent predictor of death and hospitalization in a broad spectrum of
patients suffering from systolic1–3 and
diastolic4,5 dysfunction, new-onset HF,6
and advanced chronic HF.1,2 This
review focuses on the prevalence, etiology, and pathophysiologic consequences
of anemia in patients with chronic HF.
It also reviews recent information
regarding the impact of anemia on clinical outcomes, the effects of treating anemia, and the non-hematopoietic effects
of erythropoietin (EPO)........
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