Korean J Intern Med.  2014 Jul;29(4):445-453.

Effect of anemia correction on left ventricular structure and filling pressure in anemic patients without overt heart disease

• Cho IJ
• Mun YC
• Kwon KH
• Shin GJ

Abstract

BACKGROUND/AIMS
There are few data on the effects of low hemoglobin levels on the left ventricle (LV) in patients without heart disease. The objective of this study was to document changes in the echocardiographic variables of LV structure and function after the correction of anemia without significant cardiovascular disease.
METHODS
In total, 34 iron-deficiency anemia patients (35 +/- 11 years old, 32 females) without traditional cardiovascular risk factors or cardiovascular disease and 34 age- and gender-matched controls were studied. Assessments included history, physical examination, and echocardiography. Of the 34 patients with anemia enrolled, 20 were followed and underwent echocardiography after correction of the anemia.
RESULTS
There were significant differences between the anemia and control groups in LV diameter, left ventricular mass index (LVMI), left atrial volume index (LAVI), peak mitral early diastolic (E) velocity, peak mitral late diastolic (A) velocity, E/A ratio, the ratio of mitral to mitral annular early diastolic velocity (E/E'), stroke volume, and cardiac index. Twenty patients underwent follow-up echocardiography after treatment of anemia. The follow-up results showed significant decreases in the LV end-diastolic and end-systolic diameters and LVMI, compared with baseline levels. LAVI, E velocity, and E/E' also decreased, suggesting a decrease in LV filling pressure.
CONCLUSIONS
Low hemoglobin level was associated with larger cardiac chambers, increased LV, mass and higher LV filling pressure even in the subjects without cardiovascular risk factors or overt cardiovascular disease. Appropriate correction of anemia decreased LV mass, LA volume, and E/E'.

Keyword

Anemia; Ventricular remodeling

MeSH Terms

Adult
Anemia, Iron-Deficiency/blood/diagnosis/*drug therapy/physiopathology
Biological Markers/metabolism
Case-Control Studies
Echocardiography, Doppler
Female
Heart Ventricles/*physiopathology/ultrasonography
Hematinics/*therapeutic use
Hemoglobins/metabolism
Humans
Male
Middle Aged
Prospective Studies
Recovery of Function
Time Factors
Treatment Outcome
*Ventricular Function, Left
*Ventricular Pressure
*Ventricular Remodeling
Young Adult
Biological Markers
Hematinics
Hemoglobins