Influence of anemia on cardiac function in patients with diastolic heart failure / 心血管康复医学杂志

ABSTRACT

Objective: To explore change of hemoglobin (Hb) concentration, the relationship between anemia and left ventricular function and the influence of anemia on prognosis in patients with diastolic heart failure (DHF). Methods: According to NYHA classification, a total of 176 DHF patients were divided into class Ⅱ group (n=78), class Ⅲ group (n=50) and class Ⅳ group (n=48), then Hb level and morbidity rate of anemia were analyzed in each group. According to diagnostic standard of anemia, patients were divided into anemia group (n=58, , occupied 33.0%) and non anemia group (n=118, occupied 67.0% ). Left ventricular diastolic function, mortality rate and rehospitalization rate during follow-up were compared and analyzed between two groups. Results: Along with cardiac function class rose (from class Ⅱ to class Ⅳ), Hb level showed a decreasing trend [(130±6) g/L vs. (108±4) g/L vs. (96±12) g/L], while morbidity rate of anemia gradually rose (8.97% vs. 36.0% vs. 68.8%), P<0.05 all in anemia group；Compared with non-anemia group, there were significant rise in percentages of patients with coronary heart disease (55.1% vs. 65.5%), levels of creatinine [(87.6±39.2) μmol/L vs. (113.7±59.8) μmol/L] and N terminal pro B type natriuretic peptide [NT-proBNP, (578.0±136.7) pg/ml vs. (886.0±174.8) pg/ml], and early-diastolic peak velocity deceleration time [(137±15)ms vs. (196±13)ms], and significant reduction in mitral early/late diastolic peak flow velocity [E/A, (0.87±0.32) vs. (0.62±0.29)], P<0.05 all. Compared with non-anemia group, there were significant rise in mortality rate (9.3% vs. 20.7%) and rehospitalization rate (18.6% vs. 32.8%) in anemia group during follow-up, P<0.05 all. Conclusion: DHF patients often complicate with anemia. Along with heart failure aggravates, their morbidity rate of anemia rises, and anemia may aggravate cardiac diastolic dysfunction. Mortality rate and rehospitalization rate rise in DHF patients complicated with anemia.