Anemia, Chronic Renal Failure, Heart Failure
Conditions
Keywords
Inflammation, Oxidative stress, Estimated glomerular filtration rate
Brief summary
Anemia is frequent in patients with heart failure. Few studies have clearly addressed the causes of anemia in patients with HF. The purpose of this study is to evaluate differences in blood concentrations of various substances related to inflammation, oxidative stress, renal function and other processes between individuals with 1) heart failure and anemia, 2) heart failure without anemia and 3) patients with kidney disease without systolic heart failure. This study will help to better understand the reasons why some people with heart failure have anemia.
Interventions
None listed
Sponsors
Study design
Eligibility
Inclusion criteria
Groups 1 and 2 * Age \>18 years * Group 1: hemoglobin \< 120g/L in women and \< 130 g/L in men (in agreement with the WHO definition of anemia) * Group 2: hemoglobin \> or = 120g/L in women and \> or = 130 g/L in men * Patients with chronic HF referred to a specialized HF clinic, or with a diagnosis of HF at least 6 months prior to enrolment * NYHA functional class II-IV at the time of enrolment * Patients already on CHF medical therapy (ACEI or ARBs, beta-blockers if tolerated, with or without digoxin, and loop diuretics), at stable doses for \> or = 1 month * LVEF \< or = 40% within 6 months prior to patient enrolment, by echocardiography, radionuclide ventriculography or perfusion scan, or radiologic angiography Inclusion criteria - group 3 * Age \>18 years * At least moderate CRF (eGFR \< 60ml/min/1,73m2) * With or without anemia * LVEF \> or = 50% within 6 months prior to patient enrolment, by echocardiography, radionuclide ventriculography or perfusion scan, or radiologic angiography
Exclusion criteria
(all groups): * Recent acute renal failure episode (\< 1 month) * Red blood cells (or other blood component) transfusions or EPO therapy within 3 months prior to enrolment * Iron, B12 or folic acid supplements used to treat anemia (\< 3 months) * Evidence of active GI bleeding * Recent acute coronary syndrome or decompensated HF episode (\< 1 month) * Complex congenital heart disease * Known malignant hematologic or other active neoplasia * Immunosuppressive therapy, chemotherapy or radiotherapy within 3 months prior to enrolment * Recent acute decompensation of a chronic inflammatory disease (e.g. chronic inflammatory bowel disease, rheumatoid arthritis, collagen vascular disease) within 3 months prior to enrolment * Recent viral or bacterial syndrome (\< 2 weeks) * Active or recent viral hepatitis (\< 3 months) * Pregnant women * Potential for non compliance to tests involved in this protocol * Incapacity to provide informed consent
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| TNF alpha concentrations | Visit 2 (within 2 weeks of baseline visit) |
Secondary
| Measure | Time frame |
|---|---|
| Various echocardiographic measurements, markers of inflammation, oxydative stress, neurohormonal activity and myocardial extracellular matrix turnover will be measured | Visit 2 (within 2 weeks of baseline visit) |
Countries
Canada