Anemia in heart failure with preserved ejection fraction associated with RV dysfunction, reveals research

A new study published in the Frontiers in Cardiovascular Medicine journal showed that right ventricular (RV) dysfunction is linked to anemia in heart failure with a preserved ejection fraction (HFpEF), despite traditional risk factors like diabetes, hypertension, and smoking having no effect on this association.

The critical significance of right ventricle in predicting prognosis and functional status in a variety of illnesses is becoming more well acknowledged.  In the therapy of heart failure (HF), it is critical to identify comorbidities that may impact the clinical course and responsiveness to treatment. In actuality, more than half of hospitalizations for individuals with HF are not caused by a heart problem, and a sizable portion of these hospitalizations are unrelated to HF.

Anemia is linked to left ventricular systolic dysfunction and is a frequent consequence in heart failure patients. Its impact on right ventricular function hasn't been assessed, though. Therefore, Jia Wang and colleagues investigated the potential etiology of RVD in this HF classification and looked at how anemia affected RV contractile efficiency and RV-pulmonary artery coupling in patients with HFpEF.

To assess the relationship between anemia and RV dysfunction in patients with Heart Failure with Preserved Ejection Fraction (HFpEF) and whether this relationship is influenced by traditional risk factors like smoking and hypertension, this study retrospectively examined the electronic medical records of 1,014 HFpEF patients.

In comparison to non-anemic patients, the study found that anemic patients were older and had tricuspid regurgitation (TR) and a considerably higher New York Heart Association functional class. Hemoglobin (Hb) levels were favorably correlated with the tricuspid annular plane systolic excursion (TAPSE)/pulmonary arterial systolic pressure (PASP) ratio and weakly negatively correlated with NT-pro-BNP. According to multivariate linear regression analysis, the TAPSE/PASP ratio was independently correlated with the degree of anemia, atrial fibrillation, and TR. 

Overall, the patients with HFpEF worsened by anemia experience a considerable reduction in RV function and there is a strong negative correlation between the severity of anemia and RV function, regardless of age or sex. Moreover, anemia is not linked to traditional cardiovascular risk factors such as diabetes, hypertension, and smoking as a stand-alone risk factor for RV function.

Source:

Wang, J., Jiang, J., Li, X., Tan, X., Zhou, Y., Luo, Z., Wang, X., Zhao, X., Liu, Y., Wang, M., & Zhang, C. (2024). Right ventricular function and anemia in heart failure with preserved ejection fraction. In Frontiers in Cardiovascular Medicine (Vol. 11). Frontiers Media SA. https://doi.org/10.3389/fcvm.2024.1424576