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Nephrol Dial Transplant (2001) 16: 445-448
© 2001 European Renal Association-European Dialysis and Transplant Association

Editorial Comments

A heart price to pay for anaemia

Heribert Schunkert1, and Hans-W. Hense2

1 Department of Internal Medicine II, University of Regensburg, Regensburg and 2 Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany

Introduction

Optimal tissue oxygenation requires the functional integrity of heart, lungs, and blood. If one of the partners fails in this joint task, the others have to carry some extra load. In the case of renal anaemia, the heart is requested to entertain a hyperdynamic circulation in order to compensate for the reduced oxygen transport capacity of the blood. Specifically, low blood viscosity, hypoxic vasodilatation, sympathetic activation, a-v fistula, and tachycardia force the heart to increase the cardiac output substantially in most of these patients [1,2].

Anaemia and left ventricular geometry

Obviously there is a price to pay for such profound and chronic alterations of cardiac workload, perfusion, and metabolism. In fact, left ventricular hypertrophy (LVH) is found in up to three of four patients starting on dialysis [3,4]. If we take a closer look at the hearts of such patients (but still remain at the macroscopic level), . . . [Full Text of this Article]

Erythropoietin and left ventricular geometry

Diagnostic issues

Assessment of diastolic function
Assessment of systolic function
Acknowledgments

Notes

References


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