I read the editorial of M. R. Cowie with great interest. The figures on the prognosis of heart failure were admirably clear. Nobody can deny the grim prognosis of heart failure patients, as reported by Mosterd and colleagues in the article to which the editorial refers. Cowie identifies patients who are likely to do especially badly: the very old, those with impaired renal function, diabetes an...

Many of the newer antiarrhythmic agents are said to cause minimal myocardial depression, but their hemodynamic effects have not been invasively evaluated and compared in patients with severe chronic heart failure. In a randomized, crossover study, the hemodynamic responses to single oral doses of procainamide (750 mg), tocainide (600 mg), and encainide (50 mg) given to 21 patients with severe c...

Congestive heart failure, chronic kidney insufficiency and anemia are often present in the same patient. We have coined this triad the cardio-renal anemia syndrome. We suggest that congestive heart failure can often cause chronic renal failure, with both diseases producing anemia. The anemia exacerbates the chronic heart failure, which then worsens the chronic renal failure, causing further ane...