Study On The Anemia And Iron Deficincy In Heart Failure

Heart failure,as the terminal stage of various heart diseases,has a high incidence and been associated with poor prognosis.The occurance of inflammation and neurohormonal pathway activation in heart failure makes comorbidities such as iron deficiency and anemia highly prevalent.Anemia and iron deficiency can affect the structure and function of the heart and cause worsening symptoms,decreased exercise capacity and poor prognosis in patients with heart failure.Iron homeostasis is impaired in heart failure,resulting in iron absorption and utilization disorders in patients,and finally develops to iron deficiency.The cause of anemia is multifactorial,such as iron deficiency,a blunted erythropoietin response,hemodilution and medicine etc.Therefore,the relationship between heart failure,anemia and iron deficiency are mutually reinforcing and causal.A retrospective study from Fu Wai Hospital enrolled 203 hospitalized patients with HF according to current guidelines,among them the incidence of anemia and iron deficiency are 32.02%and 33.50%.Chronic renal insufficiency is an important risk factor for anemia and iron deficiency in patients with heart failure.Compared with ferritin,TSAT plays an important role in the diagnosis of iron deficiency.Treatment of anemia and iron deficiency can improve the symptoms and prognosis of patients with heart failure.The pathophysiological mechanism of anemia should be clarified before treatment.Although transfusion and ESAs can improve hemoglobin levels,there is no relevant evidence to improve long-term prognosis.Studies have shown that the symptoms and prognosis of the iron deficiecncy patients have been significantly improved by iron supplementation therapy.Therefore,for patients with heart failure,irrespective of whether or not anaemia is present,screening for iron deficiency and to correct iron deficiency has a huge significance in clinical practice.The current treatment options for the correction of iron deficiency in the general population consist of intravenous or oral iron.Oral iron supplement has a lower intestinal absorption,and related clinical trials show that oral iron therapy has been found to be ineffective for replenishment of iron stores and improvement of clinical status in patients with heart failure.Data from several randomized controlled trials and meta-analyses of iron deficiency and systolic HF show a beneficial effect for intravenous(IV)iron in terms of quality of life and improvements in 6-min walk test New York Heart Association functional class,as well as decreased hospitalizations for HF and reduction in cardiovascular mortality rates.Recommended in the 2016 European heart failure guidelines,intravenous FCM should be consided in symptomatic patients with HFrEF and iron deficiency(Class Ila,Level A).