Relationship Of Iron Deficiency And Pro-B-Type Natriuretic Peptide In Elderly Patients Of Chronic Heart Failure

Background Patients with heart failure often combine with anemia, iron deficiency often lead to anemia. However, in recent years studies have found that, the phenomenon of chronic heart failure combine with iron deficiency is commonly, and it is nothing to do with anemia. Iron deficiency is independent risk factors affect cardiac function in heart failure people. Iron is involved in the dysfunction of myocardial cells and peripheral muscle. It is reported that iron deficiency is an independent dangerous predictor of poor prognosis of chronic heart failure people, heart failure patients combined with iron deficiency may increase the risk of death. 2012 ECS revise the heart failure guidelines and recommend some indicators such as iron element, ferritin, transferrin saturation etc. as the assessment indicators of conditions of patients with heart failure. Thus, iron deficiency may be the complications of chronic heart failure and offers a new way for the treatment and direction of heart failure people. The research about iron deficiency and heart failure is less in our country, and report in the older population has not found. AbstractObject This study explores how the ferroprotein and iron deficiency affect chronic heart failure on the elderly patients. Method Acquisition the patients because of chronic heart failure hospitalized in cardiology department of Nanjing general hospital of nanjing military region between January 2011 to December 2011, all patients’s age are greater than 75-year-old. Statistic all index such as age, sex, hypertension, diabetes, precursor of brain natriuretic peptide, hemoglobin, blood lipid, uric acid, creatinine and total bilirubin, interleukin-6, c-reactive protein, serum ferritin and iron levels and so on, all patients are divided into iron deficiency group and normal group based on the diagnostic criteria of iron deficiency.1, single sample t-test to compare the differences of index between the two groups 2, Using the pearson correlation analysis to explore the related factors to serum ferritin level, Using the partial correlation analysis controlled by the rest of the related factors one by one, research the single factor whether is correlated to serum ferritin level 3,Using linear regression analysis to explore the risk factors influencing the ferritin 4, Using the logistic regression analysis to explore the dangerous factors of incidence of iron deficiency. Results 1, Compare with the iron deficiency group, Hb significantly reduced in patients with iron deficiency group (112.1+/-14.9 vs.119.0+/-19.2, P =0.07); CRP was significantly higher (10.5+5.1 vs.8.9+/-4.6, P=0.03); a significant rise in creatinine (137.7+68.2 vs.108.3+/-49.5, P=0.002); a significant rise in brain natriuretic peptide precursor (251.2+157.1 vs.207.7+/ 94.4, P= 0.033); a significant rise in interleukin-6 (12.2+7.6 vs.9.3+/-6.3, P= 0.007). Ferritin significantly reduced (111.7+/-44.0 vs.132.8+/-95.3, P=0.048). Serum iron reduce significantly (11.2+/-5.4 vs.12.9+/-4.0, P=0.02). Uuric, acid, blood lipids, bladder inhibition C, etc. there was no statistically significant difference between the two groups.2, Bladder inhibition C, precursor of brain natriuretic peptide, interleukin-6, creatinine are significantly negative correlated to serum ferritin levels, serum iron are significantly positive related to serum ferritin level, P<0.05. In ruled out age, Hb, the interference of indexes of blood lipid, uric acid, total bilirubin, the correlation of precursor of brain natriuretic peptide, interleukin-6, creatinine, serum iron and serum ferritin still exists, the correlation of precursor of brain natriuretic peptide and ferritin decline (r=0.232 v r=0.182), the correlation of interleukin-6 and ferritin decline (r=0.192 v r=0.172), the correlation of creatinine and ferritin decline (r=0.223 v r=0.151), the correlation between urinary inhibition and ferritin disappear, P> 0.05).3, total iron binding force, interleukin-6, CRP, Pro-BNP, creatinine as factors that influence the serum ferritin level. Interleukin-6 (B=0.143), CRP (B=0.228), the Pro-BNP (B=0.242), creatinine (B=0.103) is the independent risk factors of the level of serum ferritin; total iron binding force (B= 0.519) is the protect factors of the serum ferritin level, P<0.05.4, Pro-BNP (OR= 1.121) and CRP (OR=1.078) is independent risk factors for the incidence of iron deficiency; total iron binding force (OR=0.967) is the protect factors of the prevalence of iron deficiency, P< 0.05.Conclusion 1.Urinary inhibition C, precursor of brain natriuretic peptide, interleukin-6, creatinine, serum iron is related factors to serum ferritin level; CRP, precursor of brain natriuretic peptide, interleukin-6, creatinine are negatively correlated with serum ferritin level; serum iron is positively correlated with ferritin levels 2, Precursor of brain natriuretic peptide, interleukin-6, creatinine, CRP is dangerous factors influencing serum ferritin level; total iron binding force is protect factors influencing serum ferritin level 3, precursor of brain natriuretic peptide, CRP is the risk factors of prevalence rate of iron deficiency; total iron binding force is protect factors of prevalence rate of iron deficiency.