The Related Factors Of Iron Metabolism And Anemia In Patients With Chronic Heart Failure

Objective: The aim of this study is to detect the levels of serum ferritin (SF), IRON,total iron binding capacity(TIBC) and hemoglobin(Hb) in patients with chronic heartfailure(CHF), to analyze the correlation among iron metabolism,anemia and CHF, andto explore the clinical value of them.Methods:110patients entered the study, which were admitted to the Department ofCardiology, the2nd Affiliated Hospital of Dalian Medical University from November2013to March2014. The subjects were divided into CHF group(n=70) and controlgroup (n=40). The patients with CHF were divided into class II group(n=12), class IIIgroup(n=31)and class IV group(n=27) by NYHA criterion.At the same time, they weredivided into anemia group(n=37) and non-anemia group(n=33).2-3ml venous bloodsamples were collected from all patients on the day of admission to detect the level ofNT-proBNP(N-terminal fragment brain natriuretic peptides), and by the same method ofvenous blood samples collection to detect the levels of SF,IRON,TIBC and Hb on themorning following an overnight fast. LVEDD(1eft ventricular end-diastolic dimension)and LVEF(1eft ventricular ejection fraction)were measured by using color Dopplerultrasound.The difference of the levels of SF, IRON, TIBC, Hb, and the occurrence ofanemia and ID were investigated among each group. And the correlation was analyzedbetween the levels of SF, IRON and Hb, NT-proBNP, LVEDD,LVEF respectively. Therisk factors of CHF were analyzed by multiple factors analysis. SPSS17.0softwarepackage was used for statistical analyses.Results:1.The levels of SF, IRON and Hb were obviously lower in CHF group than in control group respectively (P<0.05, respectively), and the occurrence of anemia andID was obviously higher in CHF group than in control group respectively (P<0.05,respectively). There was no significant difference of the level of TIBC between CHFgroup and control group (P>0.05).2.（1）The levels of SF, IRON and Hb were decreased with the severity ofCHF. There was significant difference of the level of SF between control group andNYHA class IV group（P＜0.05); It was also shown that there was significant differenceof the level of IRON between control group and NYHA class III group, NYHA class IVgroup respectively and between NYHA class II group, NYHA class III group andNYHA class IV group respectively(P＜0.05, respectively);The level of Hb was shownsignificant difference between control group and NYHA class II group, NYHA class IIIgroup, NYHA class IV group respectively（P＜0.05, respectively).（2）The occurrenceof anemia was nearly52.9%in CHF, and it was increased with the severity of CHF.There was significant difference between control group and NYHA class II group,NYHA class III group, NYHA class IV group respectively(P＜0.05, respectively).（3）The occurrence of ID was nearly70%in CHF. There was significant difference betweencontrol group and NYHA class III group, NYHA class IV group respectively, andbetween NYHA class II group and NYHA class III group（P＜0.05).3. The levels of SF、IRON were obviously lower in anemia group than innon-anemia group respectively (P<0.05, respectively). The occurrence of the patientswith ID was obviously higher in anemia group than in non-anemia group (P<0.05).There was no significant difference of the level of TIBC in the two groups (P>0.05).4. Hb and NT-proBNP were risk factors of CHF.(OR=1.074,P=0.046andOR=1.228, P=0.000respectively).5.The level of Hb was positively correlated with SF, IRON in CHFrespectively (r=0.314, P=0.008; r=0.486,P=0.000respectively).6. The levels of SF、IRON were not correlated with NT-proBNP、LVEDDand LVEF respectively(P>0.05respectively).Conclusion：1. The levels of SF,IRON and Hb are significantly lower in patients with CHF, and the occurrence of ID is obviously higher than anemia.Therefore, earlydetection of the iron metabolism status in patients with CHF contributes to the Irontherapy for the CHF patients with anemia.2. The decreased level of Hb can be regarded as one of the risk factorsof CHF.3. The level of Hb is positively correlated with SF, IRON in CHFrespectively. ID may be one of the main causes of the anemia in CHF.