Anemia e deficiência de ferro na insuficiência cardíaca

Abstract

Heart failure is a common problem and a major cause of mortality, morbidity and impaired quality of life. Anemia is a frequent comorbidity in heart failure and further worsens prognosis and disability. Regardless of anemia status, iron deficiency is a common and usually unidentified problem in patients with heart failure. This article reviews the mechanisms, impact on outcomes and treatment of anemia and iron deficiency in patients with heart failure. © 2013 Sociedade Portuguesa de Cardiologia Published by Elsevier España, S.L. All rights reserved. PALAVRAS-CHAVEAnemia; Deficiência de ferro; Insuficiência cardíaca; Terapêutica com ferro Anemia e deficiência de ferro na insuficiência cardíacaResumo A insuficiência cardíaca é uma patologia comum e uma causa importante de mortalidade, morbilidade e deterioração da qualidade de vida. A anemia é uma comorbilidade frequente na insuficiência cardíaca e agrava o seu prognóstico e capacidade funcional. Independentemente da presença ou não de anemia, a deficiência de ferro é um problema associado à insuficiência cardíaca muitas vezes não identificado. Este artigo revê os mecanismos, impacto prognóstico e tratamento da anemia e deficiência de ferro. © 2013 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L. Todos os direitos reservados. Case studyA 72-year-old woman with a history of poorly controlled hypertension under diuretic therapy for the previous 10 years was assessed for fatigue and dyspnea on minimal ଝ Please cite this article as: Gil VM, Ferreira JS. Anemia e deficiência de ferro na insuficiência cardíaca. Rev Port Cardiol. 2014;33:39---44.* Corresponding author. E-mail address: victorgilmd@gmail.com (V.M. Gil).exertion (NYHA class III). Her blood pressure was 150/85 mmHg and her heart rate was 88 bpm; she had faint crackles in the lung bases and ankle edema. The ECG showed voltage criteria for left ventricular hypertrophy. Her hemoglobin (Hb) level was 11.0 g/dl and her mean corpuscular volume was 85 fl, blood glucose 102 mg/dl, total cholesterol 190 mg/dl and creatinine 1 mg/dl. She was medicated with furosemide, a renin-angiotensin system inhibitor and a beta-blocker, and was referred for echocardiographic assessment. What role did the patient's Hb of 11 g/dl play in her clinical setting?

Insuficiência cardíaca associada à anemia: Uso de ferro endovenoso comparado ao placebo

“…Na insuficiência cardíaca, essa anemia pode ser ocasionada pela baixa reserva de ferro e por alterações renais, que causam uma deficiência na produção da eritropoetina, essa eritropoieitina é produzida pelos rins e é responsável pela proliferação de células percussoras de eritroides e produção de glóbulos vermelhos (Gil & Ferreira, 2014).…”

“…Além disso, a anemia tem sido considerada uma comorbidade prevalente nos pacientes com insuficiência cardíaca, sendo correspondente as reinternações hospitalares, devido a elevação da massa do ventrículo esquerdo e aumento da mortalidade (Gil & Ferreira, 2014).…”

Prevalence, risk factors, and significance of iron deficiency and anemia in nonischemic heart failure patients with reduced ejection fraction from a Himachal Pradesh heart failure registry

“…The anemia was significantly associated with female gender, history of blood loss, presence of diabetes, and low eGFR. The anemia in heart failure could be multifactorial: dilutional anemia, absolute iron deficiency, functional iron deficiency, and/or nonresponsive bone marrow to erythropoietin and erythropoietin deficiency due to frequently associated renal dysfunction 32, 33, 34…”

T cell and monocyte/macrophage activation markers associate with adverse outcome, but give limited prognostic value in anemic patients with heart failure: results from RED-HF

“…Anemia is frequently observed in HF and associated with poor prognosis [10][11][12]. Based on the established role of persistent leukocyte activation in anemia [13] and its emerging role in the progression of HF, we hypothesized that plasma levels of stable and readily detectable markers of leukocyte [17], granulysin [18]) activity could represent clinically relevant inflammatory biomarkers in HF patients.…”