Key result
Anemia is linked to ~16% lower peak VO2 in Black patients with decompensated HFrEF.
Why the study?
Black or African American patients with HFrEF have a higher prevalence of anemia and are underrepresented in clinical studies, with unclear contribution of hemoglobin to peak VO2 after acute decompensation.
Observational (n=81)
Absolute Event Rate: 11.8% vs 14.1%
p-value: p=0.010
Anemia is highly prevalent in Black African American patients with recently decompensated HFrEF and significantly correlates with reduced cardiorespiratory fitness.
Anemia may warrant evaluation in recently decompensated HFrEF; leaves open whether correction improves peak VO2 in Black patients.
BACKGROUND: Previous studies have shown that patients with heart failure with reduced ejection fraction (HFrEF) and anemia have reduced peak oxygen consumption (VO2). Black or African American (B-AA) patients have a higher prevalence of anemia and are underrepresented in clinical studies of HFrEF. The aim of this study was to determine the contribution of hemoglobin to peak VO2 in B-AA patients recently hospitalized for acute decompensated HFrEF.METHODS: We analyzed cardiopulmonary exercise testing (CPX) data measured within two weeks of discharge for acute decompensated HF in B-AA patients with HFrEF (left ventricular ejection fraction [LVEF] ≤40%) without severe anemia (Hb<8 g/dL). Blood samples were collected prior to CPX. Data are reported as median [interquartile range] and compared between groups with the Mann-Whitney, Chi-Square, and Spearman’s rank tests.RESULTS: We included 81 patients; 27 (33%) women, 57 [27-79] years of age, Body Mass Index of 33 [15-55] kg/m2 and LVEF of 30 [23-36] %. Hemoglobin ranged between 9.1 to 18.1 g/dL (median= 13.3 [11.9-14.5] g/dL); 26 (32%) were considered to have anemia based on a Hb concentration of males <13 g/dL and females <12 g/dL. Peak VO2 was lower in patients with anemia (11.8 [10.0-14.2] vs. 14.1 [10.6-17.0] mL·kg-1·min-1; P=0.010) with a significant correlation between peak VO2 and hemoglobin concentration (R=+0.455; P<0.001).CONCLUSIONS: Anemia is prevalent among B-AA patients with recently decompensated HFrEF and appears to be a significant contributor to reductions in peak VO2.
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THOMAS et al. (2022) conducted an observational in Heart failure with reduced ejection fraction (HFrEF) (n=81). Anemia vs. No anemia was evaluated on Peak VO2 (p=0.010). Anemia in Black African American patients with recently decompensated HFrEF was associated with significantly lower peak VO2 compared to those without anemia (11.8 vs. 14.1 mL/kg/min; P=0.010).
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