Author/Editor		Šebeštjen, Miran
Title		Anemija in srčno popuščanje
Translated title		Anemia and heart failure
Type		članek
Source		Slov Kardiol
Vol. and No.		Letnik 3, št. 1
Publication year		2006
Volume		str. 52-7
Language		slo
Abstract		While advances in treatment strategies and pharmacotherapy have produced a dramatic reduction in the mortality of patients with heart failure during the past 15 years, it is still a major challenge to improve patient well-being, reduce hospitalisations and further reduce mortality. The prevalence of heart failure is not decreasing and heart failure is currently the reason for hospitalisation in over 25% of admissions to internal medicine and cardiology departments. It has recently become apparent that anemia is present in 20 to 30% of patients with heart failure and the severity of anemia has important implications regarding outcome and prognosis. Anemia may be due to a numberof causes, including iron and vitamin deficiency, insidious blood loss, hemodilution, renal impairment and bone marrow depression with resistance to erythropoietin. Preliminary data show that appropriate treatment of anemia based on correction of the underlying cause with, in most patients, the addition of exogenous erythropoietin and iron therapy improves ventricular function and the clinical status. Treatment of anemia has opened a new frontier in the management of heart failure. We await the results of ongoing clinical trials for more detailed information regarding appropriate hemoglobin targets, choice of medication and dosing and the degree of improvement that may be expected when the issue of anemia is properly addressed.
Summary		Kljub napredku v zdravljenju bolnikov s srčnim popuščanjem ostaja v zadnjih 15 letih pomemben izziv, kako še dodatno izboljšati bolnikovo kakovost življenja ter zmanjšati obolevnost in umrljivost. Pojavnost srčnega popuščanja se ne manjša, hkrati pa je vsa 25% sprejemov bolnikov na kardiološke in druge internistične oddelke posledica srčnega popuščanja. Pokazalo se je, da je anemija prisotna pri 20-30% bolnikov s srčnim popuščanjem, izraženost anemije pa je pomemben napovednik poteka bolezni. Vzroki anemije so različni, med drugim pomanjkanje železa in vitaminov, kronična krvavitev, ledvična odpoved, manjša aktivnost nastajanja eritrocitov v kostnem mozgu z neodzivnostjo na eritropoetin. Prvi izsledki kažejo, da ustrezno vzročno zdravljenje anemije skupaj z dodajanjem eritropoetina in nadomeščanjem železa izboljša funkcijo levega prekata in klinično sliko. Zdravljenje anemije je odprlo novo poglavje v zdravljenju srčnega popuščanja. Študije, ki so v teku, naj bi bolj natančno odgovorile, kakšne so tarčne vrednosti hemoglobina, kakšno je ustrezno zdravljenje ter kakšno izboljšanje je pričakovati ob zdravljenju anemije.
Descriptors		HEART FAILURE, CONGESTIVE ANEMIA ERYTHROPOIETIN, RECOMBINANT