ANAEMIA AND IRON DEFICIENCY IN CHRONIC HEART FAILURE PATIENTS

This review focused on prevalence of anemia and iron deficiency (ID) in CHF and their effect on the course and prognosis of this condition. Based on evaluation of numerous laboratory data definitions of anemia and ID were suggested. Specifically, a diagnostic value of measuring serum iron, serum ferritin, transferrin saturation, total iron-binding capacity, and concentration of soluble transferrin receptors was discussed. The review highlighted the importance of measuring bone marrow iron, which is rarely used in everyday clinical practice even though this test is considered a "gold standard" of ID diagnosis. The review provided an insight into pathogenetic mechanisms of ID in CHF including insufficient iron supply, role of inflammation, erythropoietin, RAAS, and effects of some pharmacological therapies. The authors described physiological consequences of ID and anemia, activation of hemodynamic and non-hemodynamic compensatory mechanisms, which develop in response to anemia and not infrequently aggravate CHF. Special attention was paid to current approaches to treatment of anemia and ID in CHF, including a discussion of efficacy and safety of oral and intravenous dosage forms of iron and hemopoiesis stimulators.