High serum erythropoietin levels are normalized during treatment of congestive heart failure with enalapril

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Abstract
Fyhrquist F, Karppinen K, Honkanen T, Saijonmaa O, Rosenlöf K (Department of Internal Medicine, Päijät-Häme Central Hospital, Lahti and Minerva Institute for Medical Research, Helsinki, Finland). High serum erythropoietin levels are normalized during treatment of congestive heart failure with enalapril. Eighteen patients with dilated cardiomyopathy (three female, mean age 57 years), were treated for 48 weeks with enalapril added to digoxin and diuretic therapy for congestive heart failure of New York Heart Association (NYHA) functional class II (three patients), III (eight patients) and IV (seven patients), respectively. Serum levels of erythropoietin (EPO) were raised at the start (37 ± 12.8 pmol 1−1; mean ± SD) and were normalized during enalapril treatment (17.5 ± 9.9 pmol 1−1 at 48 weeks; P < 0.001). Serum EPO correlated at the start with NYHA functional class (r = 0.68; P < 0.05). Normalization of elevated serum EPO concentrations during treatment with enalapril paralleled clinical and haemodynamic improvement, and probably reflected relief from renal hypoxia.