I. Anemia and Heart Function
II. Clinical Studies

GLOSSARY
angina chest pain caused by temporary lack of blood to an area
of heart muscle cells, usually caused by severe obstruction of
the artery supplying blood to the segment of cells. arrhythmia general term for an irregularity or rapidity of the
heartbeat, an abnormal heart rhythm. cardiac dysfunction the normal function of the heart is
reduced; abnormal heart function. creatinine breakdown of proteins excreted into the urine by the
kidneys so that the composition in the bloodstream remains
relatively constant. ejection fraction the fraction of blood ejected from the heart
into the arteries, normally this ranges from 60 to 75%; a low
ejection fraction is less than 40%. heart failure a failure of the heart to pump sufficient blood
from the chambers into the aorta; inadequate supply of blood
reaches organs and tissues.
decrease in systolic blood pressure, mmHg (normal pressure range 100 to
hypotension marked
usually less than 95
140 mm Hg) ischemia temporary lack of blood and oxygen to an area of
cells, for example, the heart muscle, usually due to severe
obstruction of the artery supplying blood to this area of cells. myocardium the heart muscle.

• I. ANEMIA AND HEART FUNCTION
  The heart and the circulating system through arteries, veins, and capillaries must accomplish two goals: (1) delivery of oxygen and nutrients to organs and the peri¬pheral tissues and (2) removal of metabolic waste products that accumulate throughout the body. Oxygen is carried by hemoglobin in red blood cells to the tissues. The normal level of hemoglobin in circulating blood is 11.5–15.5 g/dl (115–155 g/L) in women and 15 to 17 g/dl in men.
• II. CLINICAL STUDIES
  Study question: Mild anemia occurs commonly in patients with heart failure, the detrimental effects of mild to moderate anemia on cardiac function and the effect of correction has not been adequately addressed by controlled studies. Many studies consider anemia to be a rare precipitating cause of heart failure and of hospitalization for heart failure. Silverberg et al. studied the effect of correcting anemia with erythropoietin (EPO) and intra¬venous iron.
• BIBLIOGRAPHY
  Anand, I., McMurray, J. J. V., Whitmore, J. et al. Anemia and its relationship to clinical outcome in heart failure. Circulation, 110:149–154, 2004.