Статья
Анемия и хроническая сердечная недостаточность
В настоящее время уделяют большое внимание сочетанию хронической сердечной недостаточности (ХСН) с анемией, которая ухудшает течение СН и неблагоприятно влияет на прогноз. Основным звеном в развитии анемии при ХСН является абсолютная или относительная недостаточность эритропоэтина, обусловленная влиянием провоспалительных цитокинов, а также почечная дисфункция. Работы последних лет показали, что коррекция даже умеренной анемии при ХСН повышает толерантность к физическим нагрузкам, снижает функциональный класс ХСН (NYHA), улучшает качество жизни, структурнофункциональные показатели сердца, уменьшает потребность в диуретиках и числе госпитализаций. Однако отсутствуют данные о влиянии коррекции анемии на долгосрочную выживаемость пациентов, а также уровне гемоглобина, при котором следует начинать коррекцию анемии, и целевых значениях гемоглобина, безопасных для каждого пациента.
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