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Association between left ventricular dysfunction, anemia, and chronic renal failure

Analysis of the Heart Failure Prevalence and Predictors in Turkey (HAPPY) cohort

Zusammenhang zwischen linksventrikulärer Dysfunktion, Anämie und chronischer Niereninsuffizienz

Auswertung der Heart-Failure-Prevalence-and-Predictors-in-Turkey (HAPPY)-Kohorte

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Abstract

Background

Anemia and chronic renal failure (CRF) are frequent comorbidities in patients with heart failure (HF), and they have been reported to be associated with increased mortality and hospitalization rates. HF, anemia, and CRF have been reported to interact with each other forming a vicious cycle termed cardio-renal-anemia syndrome. The aim of the present study was to evaluate the association of HF, anemia, and CRF using data from the large-scale“Heart Failure Prevalence and Predictors in Turkey (HAPPY)” study.

Patients and methods

Among the HAPPY cohort, 3,369 subjects who had either left ventricular dysfunction (LVD) or normal left ventricular function on echocardiography or normal serum NT-proBNP levels were included in this analysis.

Results

The prevalence of anemia and CRF was significantly higher in patients with LVD compared with subjects with normal ventricular function (20.7 % vs. 4.0 % and 19.0 % vs. 3.7 %, respectively; p < 0.001 for each). Binary logistic regression analyses for the presence of LVD, anemia, and CRF demonstrated that each one was an independent predictor for the presence of the others.

Conclusion

These findings point to the presence of cardio-renal-anemia syndrome and the necessity of treating these comorbidities in patients with HF.

Zusammenfassung

Hintergrund

Anämie und chronische Niereninsuffizienz (CRF) sind häufige Begleiterkrankungen bei Patienten mit Herzinsuffizienz (HF) und stehen der Literatur zufolge mit erhöhten Mortalitäts- und Hospitalisierungsraten in Zusammenhang. Für HF, Anämie und CRF ist beschrieben worden, dass sie miteinander interagieren und so einen Teufelskreis verursachen, der als kardiorenales Anämiesyndrom bezeichnet wird. Ziel der vorliegenden Studie war es, den Zusammenhang von HF, Anämie und CRF anhand der Daten der umfangreichen HAPPY-Studie (Heart fAilure Prevalence and Predictors in TurkeY) zu untersuchen.

Methoden

Von der HAPPY-Kohorte wurden 3369 Teilnehmer in die Auswertung einbezogen, bei denen durch Echokardiographie oder Serum-NT-proBNP-Werte entweder eine linksventrikuläre Dysfunktion (LVD) oder eine normale linkventrikuläre Funktion nachweisbar war.

Ergebnisse

Die Prävalenz von Anämie und CRF war bei Patienten mit LVD signifikant höher als bei Personen mit normaler Ventrikelfunktion (20,7 % vs. 4,0 % bzw. 19,0 % vs. 3,7 %; jeweils p < 0,001). Die binäre logistische Regressionsanalyse für das Vorliegen einer LVD, Anämie und CRF ergaben, dass das Vorliegen einer dieser Faktoren einen unabhängigen Prädiktor für das Vorliegen der anderen Faktoren darstellte.

Schlussfolgerung

Diese Befunde weisen auf das Vorliegen eines kardiorenalen Anämiesyndroms und die Notwendigkeit hin, derartige Begleiterkrankungen bei Patienten mit HF zu behandeln.

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Compliance with ethical guidelines

Conflict of interest. A. Kepez, B. Mutlu, M. Degertekin, and C. Erol state that there are no conflicts of interest. All studies on humans described in the present manuscript were carried out with the approval of the responsible ethics committee and in accordance with national law and the Helsinki Declaration of 1975 (in its current, revised form). Informed consent was obtained from all patients included in studies.

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Authors and Affiliations

  1. Department of Cardiology, Marmara University Faculty of Medicine, Mimar Sinan Caddesi No. 41 Üst Kaynarca, Istanbul, Turkey

    A. Kepez MD & B. Mutlu

  2. Department of Cardiology, Yeditepe University Faculty of Medicine, Istanbul, Turkey

    M. Degertekin

  3. Department of Cardiology, Ankara University Faculty of Medicine, Ankara, Turkey

    C. Erol

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  1. A. Kepez MD
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  2. B. Mutlu
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Correspondence to A. Kepez MD.

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Kepez, A., Mutlu, B., Degertekin, M. et al. Association between left ventricular dysfunction, anemia, and chronic renal failure. Herz 40, 616–623 (2015). https://doi.org/10.1007/s00059-013-3967-z

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  • DOI: https://doi.org/10.1007/s00059-013-3967-z

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