Relationship of resting hemoglobin concentration to peak oxygen uptake in heart failure patients

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Abstract

Anemia is frequent in chronic heart failure (HF). To calculate what change in peak oxygen uptake (V̇O2) should be expected in the event of changes in hemoglobin concentration, we studied the correlation between peak V̇O2 and hemoglobin concentration in a large HF population. We carried out retrospective analysis of all cardiopulmonary exercise tests (CPET) performed in our HF Clinic between June 2001 and March 2009 in HF patients who had a resting hemoglobin concentration measurement taken within 7 days of the CPET. We collected 967 CPETs, 704 tests were considered maximal and analyzed. We identified 181 patients (26%) as anemic. Peak V̇O2 was lower (P <0.001) in anemic patients (971 ± 23 ml/min) compared with nonanemic (1243 ± 18 ml/min). The slope of the V̇O2 vs. hemoglobin ratio was 109 ml/min/g/dl at peak exercise. This correlation remained significant also when several confounding variables were analyzed by multivariate analysis. As an average, each gram of hemoglobin accounts, at peak exercise, for 109 ml/min change in V̇O2 which is equivalent to 0.97 ml/min/kg. Therefore, in HF patients anemia treatment should increase V̇O2 by 109 ml/min for each g/dl of hemoglobin increase.

Original languageEnglish
Pages (from-to)414-417
Number of pages4
JournalAmerican Journal of Hematology
Volume85
Issue number6
DOIs
Publication statusPublished - Jun 2010

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Hemoglobins
Heart Failure
Oxygen
Exercise Test
Anemia
Exercise
Confounding Factors (Epidemiology)
Multivariate Analysis
Population
Therapeutics

ASJC Scopus subject areas

  • Hematology

Cite this

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title = "Relationship of resting hemoglobin concentration to peak oxygen uptake in heart failure patients",
abstract = "Anemia is frequent in chronic heart failure (HF). To calculate what change in peak oxygen uptake (V̇O2) should be expected in the event of changes in hemoglobin concentration, we studied the correlation between peak V̇O2 and hemoglobin concentration in a large HF population. We carried out retrospective analysis of all cardiopulmonary exercise tests (CPET) performed in our HF Clinic between June 2001 and March 2009 in HF patients who had a resting hemoglobin concentration measurement taken within 7 days of the CPET. We collected 967 CPETs, 704 tests were considered maximal and analyzed. We identified 181 patients (26{\%}) as anemic. Peak V̇O2 was lower (P <0.001) in anemic patients (971 ± 23 ml/min) compared with nonanemic (1243 ± 18 ml/min). The slope of the V̇O2 vs. hemoglobin ratio was 109 ml/min/g/dl at peak exercise. This correlation remained significant also when several confounding variables were analyzed by multivariate analysis. As an average, each gram of hemoglobin accounts, at peak exercise, for 109 ml/min change in V̇O2 which is equivalent to 0.97 ml/min/kg. Therefore, in HF patients anemia treatment should increase V̇O2 by 109 ml/min for each g/dl of hemoglobin increase.",
author = "Piergiuseppe Agostoni and Elisabetta Salvioni and Chiara Debenedetti and Carlo Vignati and Gaia Cattadori and Mauro Contini and Damiano Magr{\`i} and Pietro Palermo and Erica Gondoni and Denise Brusoni and Cesare Fiorentini and Anna Apostolo",
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AU - Agostoni, Piergiuseppe

AU - Salvioni, Elisabetta

AU - Debenedetti, Chiara

AU - Vignati, Carlo

AU - Cattadori, Gaia

AU - Contini, Mauro

AU - Magrì, Damiano

AU - Palermo, Pietro

AU - Gondoni, Erica

AU - Brusoni, Denise

AU - Fiorentini, Cesare

AU - Apostolo, Anna

PY - 2010/6

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N2 - Anemia is frequent in chronic heart failure (HF). To calculate what change in peak oxygen uptake (V̇O2) should be expected in the event of changes in hemoglobin concentration, we studied the correlation between peak V̇O2 and hemoglobin concentration in a large HF population. We carried out retrospective analysis of all cardiopulmonary exercise tests (CPET) performed in our HF Clinic between June 2001 and March 2009 in HF patients who had a resting hemoglobin concentration measurement taken within 7 days of the CPET. We collected 967 CPETs, 704 tests were considered maximal and analyzed. We identified 181 patients (26%) as anemic. Peak V̇O2 was lower (P <0.001) in anemic patients (971 ± 23 ml/min) compared with nonanemic (1243 ± 18 ml/min). The slope of the V̇O2 vs. hemoglobin ratio was 109 ml/min/g/dl at peak exercise. This correlation remained significant also when several confounding variables were analyzed by multivariate analysis. As an average, each gram of hemoglobin accounts, at peak exercise, for 109 ml/min change in V̇O2 which is equivalent to 0.97 ml/min/kg. Therefore, in HF patients anemia treatment should increase V̇O2 by 109 ml/min for each g/dl of hemoglobin increase.

AB - Anemia is frequent in chronic heart failure (HF). To calculate what change in peak oxygen uptake (V̇O2) should be expected in the event of changes in hemoglobin concentration, we studied the correlation between peak V̇O2 and hemoglobin concentration in a large HF population. We carried out retrospective analysis of all cardiopulmonary exercise tests (CPET) performed in our HF Clinic between June 2001 and March 2009 in HF patients who had a resting hemoglobin concentration measurement taken within 7 days of the CPET. We collected 967 CPETs, 704 tests were considered maximal and analyzed. We identified 181 patients (26%) as anemic. Peak V̇O2 was lower (P <0.001) in anemic patients (971 ± 23 ml/min) compared with nonanemic (1243 ± 18 ml/min). The slope of the V̇O2 vs. hemoglobin ratio was 109 ml/min/g/dl at peak exercise. This correlation remained significant also when several confounding variables were analyzed by multivariate analysis. As an average, each gram of hemoglobin accounts, at peak exercise, for 109 ml/min change in V̇O2 which is equivalent to 0.97 ml/min/kg. Therefore, in HF patients anemia treatment should increase V̇O2 by 109 ml/min for each g/dl of hemoglobin increase.

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