Correlation between concentration of pathological cytokines and erythropoietin in patients with chronic heart failure with anemic syndrome

Abstract

Aim: to study correlation between concentration of pathological cytokines and erythropoietin in patients with chronic heart failure with anemic syndrome and also to prove importance of this communication for need of appointment erythropoietin excitants. Patients and methods: 94 patients with chronic heart failure of New York Heart Association (NYHA) class III-IV a left ventricular ejection fraction of 40% or less with anemia w ere included in investigation (58 males, 36females). Anemia was detected when hemoglobin (Hb) was less than 120g/l in males and less than 110 g/l in females. 46 patients received traditional treatment of CHF (I group) and 48 patients were treated additionally with erythropoietin (EPO) (II group). Percutaneous EPO 50 IU monthly to patients without iron deficiency for a period of 6 months. Echocardiography parameters, plasma NT and pro-BNP, cytokines, EPO, ferritin and 6-minute walking test were assessed at baseline and after treatment. Results: in patients with CHF and anemia in II group erythropoietin treatment increased Hb levels by 22,4% (p <0,05) and erythropoietin serum levels by 29,3±4,3 IU/ml (p <0,001). Increased erythropoietin level was associated with decrease of cytokines levels: IL 1 by 36,6% (p <0,001), IL 6 by 54,3% (p <0,05), TNFa by 48,3% (p <0,05) compared with patients in I group. In erythropoietin- treated patients there is a significant increase of LVEF by 19,04% (p <0,05) compared with patients from I group. A greater 6-minute distance walked on exercise testing increased by 76,6% (p <0,05) after treatment with erythropoietin. Conclusions: Correction of anemia in patients with chronic heart failure with percutaneous erythropoietin injections 50 IU monthly for 6 month period to improve erythropoietin deficit and cytokines aggression and associated anemia, symptoms and quality of life.