Cardiovascular Drugs and Therapy

, Volume 22, Issue 1, pp 37–44

Correction of Anemia with Erythropoietin in Chronic Kidney Disease (stage 3 or 4): Effects on Cardiac Performance

  • Konstantinos D. Pappas
  • Chariklia D. Gouva
  • Konstantinos P. Katopodis
  • Petros M. Nikolopoulos
  • Panagiotis G. Korantzopoulos
  • Lampros K. Michalis
  • John A. Goudevenos
  • Kostas C. Siamopoulos
Article

DOI: 10.1007/s10557-007-6075-6

Cite this article as:
Pappas, K.D., Gouva, C.D., Katopodis, K.P. et al. Cardiovasc Drugs Ther (2008) 22: 37. doi:10.1007/s10557-007-6075-6

Abstract

Background

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.

Patients and methods

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 ≥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.

Results

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/m2, 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.

Conclusions

Correction of anemia with rhuEpo in patients with CKD seems to improve cardiac performance and geometry.

Key words

chronic kidney disease cardiac performance systolic function diastolic function erythropoietin echocardiography tissue doppler imaging 

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Konstantinos D. Pappas
    • 1
  • Chariklia D. Gouva
    • 2
  • Konstantinos P. Katopodis
    • 2
  • Petros M. Nikolopoulos
    • 2
  • Panagiotis G. Korantzopoulos
    • 1
  • Lampros K. Michalis
    • 1
  • John A. Goudevenos
    • 1
  • Kostas C. Siamopoulos
    • 2
    • 3
  1. 1.Department of Cardiology, Medical SchoolUniversity of IoanninaIoanninaGreece
  2. 2.Department of Nephrology, Medical SchoolUniversity of IoanninaIoanninaGreece
  3. 3.Department of Internal Medicine, Medical SchoolUniversity of IoanninaIoanninaGreece