Faculdade de Medicina de Botucatu – UNESP, São Paulo, SP – Brazil.
Arq Bras Cardiol. 2013 Jul;101(1):87-92. doi: 10.5935/abc.20130126.
Anemia is a prevalent comorbidity and marker of a poorer prognosis in patients with heart failure (HF). Its clinical relevance, as well as its pathophysiology and the clinical management of these patients are important subjects in the specialized literature. In the present review, we describe the current concepts on the pathophysiology of anemia in HF, its diagnostic criteria, and the recommendations for iron supplementation. Also, we make a critical analysis of the major studies showing evidences on the benefits of this supplementation. The four main components of anemia are addressed: chronic disease, dilutional, "renal" and malabsorption. In patients with HF, the diagnostic criteria are the same as those used in the general population: serum ferritin levels lower than 30 mcg/L in patients without kidney diseases and lower than 100 mcg/L or serum ferritin levels between 100-299 mcg/L with transferring saturation lower than 20% in patients with chronic kidney diseases. Finally, the therapeutic possibilities for anemia in this specific patient population are discussed.
贫血是心力衰竭（HF）患者常见的合并症和预后不良的标志物。其临床相关性，以及其病理生理学和这些患者的临床管理是专业文献中的重要课题。在本次综述中，我们描述了 HF 中贫血的病理生理学、诊断标准以及铁补充的建议的最新概念。还对主要研究进行了批判性分析，这些研究提供了关于这种补充的益处的证据。贫血的四个主要组成部分是慢性疾病、稀释性、“肾脏”和吸收不良。在 HF 患者中，诊断标准与普通人群相同：无肾脏病患者的血清铁蛋白水平低于 30 mcg/L，而慢性肾脏病患者的血清铁蛋白水平在 100-299 mcg/L 之间，转铁饱和度低于 20%。最后，讨论了针对该特定患者人群贫血的治疗可能性。
