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Erythropoietin und Herzinsuffizienz

Erythropoietin and cardiac failure

  • Klinische Pharmakologie
  • Published:
Der Kardiologe Aims and scope

Zusammenfassung

Die Anämie bei chronischer Herzinsuffizienz (CHF) ist ein prognostisch unabhängiger, negativer Prädiktor für Mortalität. Aktuelle klinische Untersuchungen beschäftigen sich daher mit der Frage, ob eine Normalisierung des Hb durch Therapie mit Eisen und/oder rekombinantem, humanem Erythropoietin (rHuEPO) eine Verbesserung der Prognose bei Herzinsuffizienz bewirkt. Experimentell konnten Hb-unabhängige Effekte via gewebespezifische EPO-Rezeptoren nachgewiesen werden. So wird in aktuellen klinischen Studien der mögliche Nutzen einer akuten, hoch dosierten rHuEPO-Therapie bei Infarktpatienten untersucht. Zusammenfassend ist die rHuEPO-Therapie bei chronischer Herzinsuffizienz aktuell als rein experimentell einzustufen. Erst die jetzt laufenden klinischen Studien werden zeigen, ob und in welcher Dosierung die rHuEPO-Therapie bei Herzinsuffizienz eine Ergänzung der bisherigen Therapieansätze darstellt.

Abstract

Anemia in chronic heart failure (CHF) is an independent predictor of mortality. Current clinical studies therefore explore the possibility that iron supplementation and/or therapy with recombinant, human erythropoietin (rHuEPO) improves the outcome in CHF patients. However, recent studies in patients with impaired renal function did not find any effects on cardiovascular endpoints by raising haemoglobin above 11 mg/dl. Independent of its effect on Hb levels, EPO was shown to have beneficial effects on left ventricular remodeling after infarct through direct effects on tissue-resident EPO receptors. These results have led to clinical studies testing the effect of single, high doses of rHuEPO after myocardial infarction. So far, only safety data are available. These show this approach to be safe. In summary, EPO therapy in CHF is currently experimental; data from ongoing clinical trials are eagerly awaited in order to judge the potential of this approach for patients with CHF.

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Interessenkonflikt

PD Bergmann und Prof. Fliser haben Vortragshonorare und Forschungsunterstützung durch verschiedene Pharmafirmen erhalten, u. a. Hofmann LaRoche und Amgen (Hersteller von EPO-Derivaten). Trotz des möglichen Interessenkonflikts ist der Beitrag unabhängig und produktneutral.

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Authors and Affiliations

  1. Abteilung Kardiologie,Franz Volhard Klinik, Charité Campus Buch & HELIOS Kliniken Berlin, Wiltbergstraße 50, 13125, Berlin, Deutschland

    M.W. Bergmann

  2. Abteilung Nephrologie, Medizinische Hochschule Hannover, Hannover, Deutschland

    D. Fliser

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  1. M.W. Bergmann
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  2. D. Fliser
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Correspondence to M.W. Bergmann.

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Bergmann, M., Fliser, D. Erythropoietin und Herzinsuffizienz. Kardiologe 1, 43–49 (2007). https://doi.org/10.1007/s12181-007-0001-9

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  • DOI: https://doi.org/10.1007/s12181-007-0001-9

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