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The purpose of investigation to study relation to levels of erythropoietin and pathological cytokine of patients in chronic heart failure with anaemic syndrome and erythropoietinic effect and security of continuous erythropoietin receptor activator methoxy polyethilenglicol-epoietin beta (MEB) its impact on this relation and on regress of symptoms chronic heart failure.
94 patients with chronic heart failure of New York Heart Association (NYHA) class ІІІ-ІV a left ventricular ejection fraction of 40% or less with anaemia were included in investigation. Mean age of patients 59,7±1,6 years (58 males, 36 females). A hemoglobin level of less 120 g/l by males and less 110g/l by females. 46 patients were treated basis treatment of CHF (І group) and 48 patients were treated with MEB (ІІ group). Percutaneous MEB in dose 50 IU in day in one months patients without iron deficiency to receive in follow-up on 6 months. Echocardiographic indices of LV systolic and diastolic function, plasma NT pro BNP, cytocine, erythropoietin, ferritin and 6 minute walked distance were assessed at baseline and posttreatment.
On the patients CHF with anemic syndrome in ІІ group MEB treatment the level Hb increased on 22,4% (p<0,05) and erythropoietin levels in serum plasma increased to 29,3±4,3 IU/ml (p<0,001).The increase the level of erythropoietin connected with the decrease of level pathological cytokines: Il-1on 36,6% (p<0,001), Il-6 on 54,3% (p<0,05),TNF-α on 48,3% (p<0,05) compared with of patients receiving І group. MEB treatment had a significantly increase LVEF on 19,04% (p<0,05) as compared with of patients receiving І group.A greater 6-minute distance walked on exercise testing increased on 76,6% (p<0,05) after treatment MEB.There was also a significant fall in serum NT pro BNP levels from 387,4±52,3 fmol/ml to 198,1±30,3 fmol/ml (p<0,01).
On the patients of CHF with anemic syndrome erythropoietin failure increase sytokincal aggression with worsens clinical picture of the illness. Correction of anemic syndrome with application of percutaneus ME B in dose 50 IU in day in one month in follow-up 6 months effective to improve erythropoietin failure and cytokinic aggression connected to it and anemia; clinical symptoms and quality of life in anaemic CHF patients.