Therapeutic correction of anemia in patients with chronic heart failure of ischemic origin with iron’s drugs in combination with quercetin

Abstract

The aim of the study was to evaluate the effectiveness of anemia's correction in patients with chronic heart failure of ischemic genesis with iron's drugs in comparison with their combination with quercetin based clinical, cardiohemodynamic characteristic, indicators of erythropoiesis and cytokines. Materials and methods. Tere were examinated 120 patients with chronic heart failure due to iscemic heart disease and anemia. Chronic heart failure FC II diagnosed in 49 pations, III FK – 42 and FC IV – 29. Patients with CHF and anemia were divided in 2 groups. 1 group recieved standart therapy and iron’s drugs, the 2 group was additionally assigned quercetin. Hemoglobin, serum iron, erythropoetin and ferritin levels were evaluated. Results. After the therapy, the level of erythrocytes, hemoglobin, hematocrit, serum iron in the first group increased by 5.3, 20.3, 12.8, 40.2 %, respectively, in the II group – by 9.2, 25.6, 14.2 and 62.4 % respectively. The level of erythropoietin before the onset of therapy in both groups significantly exceeded the control indices. After treatment it significantly decreased in the I group by 20.4 %, in II – by 28.2 %. A significant increase of the level of tumor necrosis factor-α, interleukin-1β was determined in both groups of patients with chronic heart failure and anemia, In first group level of tumor necrosis factor -α significantly decreased by 14.2 %, interleukin-1β – on 6.5 %, in II group – by 26.6 % and 28.1 % respectively after the treatment. In the first group the end-diastolic diameter was significantly decreased by 7.7 %, the end-diastolic volume by 9.5 %, the end-systolic diameter by 7.9 %, the end systolic volume by 7.5 %, the ejection fraction increased by 14.4 % and indicators of a 6-minute walk test by 19.4 %, quality of life parameters by 24.2 %, in II group the end diastolic diameter decreased by 11.3 %, the end diastolic volume by 10.2 %, the end systolic diam, eter by 9.4 %, the end systolic volume by 13.6 %, the ejection fraction increased by 18.3 %, the distance of 6-minute walk test improved by 34.0 % the quality of life parameters by 32.9 %. Conclusions. It has been detected, that anemia’s correction in patients with CHF, who received combination of standart treatment with iron’s drugs accompanied by an increase in the level of erythrocytes, hemoglobin, iron, and decreased level in the initially increased levels of erythropoetin, ferritin, tumor necrosis factor-α, interleykin-1β. Favorable changes in erythropoiesis were accompanied by a positive dynamics of the morphofunctional parameters of the myocardium, the distance during the 6-minute walk test and the quality of life indicators. Quercetin, included in the scheme of therapy of patients with chronic heart faiulure and anemic syndrome, potentiated hematopoietic and hemodynamic effects of therapy.

Keywords

• chronic heart failure
• anemia
• hematinics
• quercetin