0:00:01i indoctrinated well
0:00:03and i'm doctor fisher
0:00:05i think it is a frequent but impatiently heart failure the two frequency of funding
0:00:10heart figure not only influenced by the definition used but it also depends on patient
0:00:16population that is being studied
0:00:18unfortunately the precise got up to define and in impatiently heart failure be made arbitrarily
0:00:23and there are no consensus in regards to the definition
0:00:27for the remote the threshold haemoglobin levels at which phonemic treatment should be initiated impatiently
0:00:32card figure remains so for their complex and controversial clinical question
0:00:39optimal method of treating planning in patients with heart figure be there to be more
0:00:44it was estimated agent is also unclear
0:00:48or article tries to discuss this complexity is related to a nickname patient meets heart
0:00:53failure
0:00:54the article discusses mechanisms involved in the development of training in hartford complex interaction of
0:01:00underlying and efficiency effectively production people resistance
0:01:04activation of million and you dance in l two strong system along the presence of
0:01:09what aligns chronic disease and to implement she said to kind activation are some of
0:01:14these
0:01:14advanced age female gender and presence of see katie often predisposed training i don't deficiency
0:01:21in any in any of chronic disease are two most common cause offending in heart
0:01:25failure patients
0:01:26i don't deficiencies diagnosed consider i don't transmit and saturation and thirty do not show
0:01:31and i don't by mining pasties l e
0:01:34any of chronic disease in hartford is diagnosed and concentrations of i don't translation saturation
0:01:39and i don't binding capacity or low in fat in as well as transit several
0:01:44labels that elevated however this criteria not always
0:01:48actually
0:01:50once considered computational for your name is now emerging as a potential contributor and that
0:01:56there really target impatiently heart failure
0:01:59the potential benefit between a name in hartford mutation includes implementing the oxygen deteriorated issues
0:02:06improvement in exercise tolerance attenuation of words cardiac remodelling and potential improvement in had treated
0:02:13quality you like
0:02:16given a significant risk related to what in overload back translation is usually not the
0:02:21first line therapy impatiently chart here except those with cv are symptomatic anaemia
0:02:28one may consider or and there would be but different testing side effects are frequently
0:02:33and often resulting in for compliance
0:02:35in addition large quantities of were required for extended period of time three times two
0:02:41hours
0:02:41although directly with intravenous i don't has shown promising results in recent years
0:02:46largescale multi centre randomised controlled files have not been available studies have not reported consistent
0:02:52improvement in symptoms quality of life with people order to put in fact that the
0:02:57entire video stations
0:02:59this may be partly due to one masking of underlying functional i don't efficiency bit
0:03:03you sit at a be a little
0:03:05combination therapies may provide reasonable solution but multi centre randomised double blind control trials that
0:03:12still lacking particularly in elderly any patients with heart failure given the recent evidence linking
0:03:18yes it added to achieve high target label of remote location in any patients with
0:03:23kidney disease
0:03:24to high mortality and thirty was to complications it would be extremely important to be
0:03:28cautious in utilizing this approach when treating patients with in heart failure whether newer yes
0:03:36able have different outcomes remains to be explored in this population
0:03:40i am i think that these complex mediators of any in figure mailorder the treatment
0:03:46of in of heart failure in future thank you very much