EPO and nutritional disorder: The aetiology of anaemia in heart failure is multifactorial, with absolute and functional iron deficiency, decreased erythropoietin levels and erythropoietin resistance, inflammatory state and heart failure medications being the important causative factors [14]. Heart failure can lead to anaemia via a large number of mechanisms, and anaemia, in turn, can lead to an increased cardiac workload and possible further deterioration of cardiac function and prognosis [15].