Anemia from the perspective of the problem of chronic heart failure: pathogenesis and laboratory diagnosis

Abstract

Analyzing the data of the contemporary world literature, this paper presents the main points regarding etiological factors and pathogenesis of the contraction of anemia in patients with chronic heart failure. The literature data on the present state of the problem of anemia of iron deficiency genesis, epidemiology and the relation of iron metabolism to various factors have been provided. The attention has been focused on the necessity and, at the same time, the complexity and the features of the diagnosis of absolute and functional iron deficiency in the event of chronic heart failure. Aim. To analyze the contemporary views on the etiopathogenesis of anemia of iron deficiency genesis and their impact on the course of chronic heart failure and the quality of patients' life, as well as to generalize the main laboratory and diagnostic criteria of iron deficiency anemia and anemia of chronic diseases in patients with chronic heart failure according to the most recent studies and standards of hematological indicators. Material and Methods. The analysis and generalization of the results of current research devoted to the study of anemia as a new therapeutic target in the event of chronic heart failure, have been carried out. Forty literary primary sources, revealing contemporary views on this problem in more detail, have been selected. Results and Discussion. Chronic heart failure is characterized by a progressive growth rate in the population and remains an urgent problem of our time. The combination of chronic heart failure with other comorbid states, which can significantly complicate its course, attracts great attention of the researchers. More and more sources appear indicating the high incidence of anemia as of a clinical and hematological syndrome among patients with cardiovascular diseases. From this perspective, the combination of chronic heart failure with anemia appears to be quite problematic from the practical point of view. The role of anemia as of an independent risk factor in the event of chronic heart failure has been studied in a large number of studies. It has been proven that anemia has an adverse impact on the clinical prognosis of patients with chronic heart failure, decreases functional ability and quality of patients' life, increases the number of hospital admissions , the progression of remodeling of left ventricle myocardium and the emergence of resistance to standard treatment, and increases general and cardiovascular mortality. The prevalence of anemiae among patients with chronic heart failure, according to various data, has sufficiently large discrepancies, which are explained by previously unavailable single approach to the diagnosis of anemia. However, according to recent studies, precise diagnostic criteria, offering an opportunity to differentiate different types of anemic syndromes of iron deficiency genesis, have been approved. Correspondingly, an accurate assessment of the genesis of anemia is required for choosing the right approach to its correction. Conclusions. Patients with chronic heart failure and anemia persent a particular problem for practical healthcare. An adverse impact of anemia on the course of chronic heart failure has been proven. The correction of anemic syndrome is of great importance for effective treatment of chronic heart failure. For this purpose, it is essential to define the pathophysiological variant of anemia, which directly determines the effectiveness of the correction. Among various variants of anemia in the event of chronic heart failure, the most frequent ones are iron deficiency anemia and anemia of chronic diseases or their combination. Nowadays, specific laboratory criteria for differential diagnosis of various variants of anemia in this category of patients have been defined.

Keywords

• iron deficiency anemia, anemia of chronic diseases, chronic heart failure