Sîrbu Oana, Floria Mariana, Dascalita Petru, Stoica Alexandra, Adascalitei Paula, Sorodoc Victorita, Sorodoc Laurentiu
Grigore T. Popa University of Medicine and Pharmacy; Iasi-Romania.
Anatol J Cardiol. 2018 Jul;20(1):52-59. doi: 10.14744/AnatolJCardiol.2018.08634.
Anemia associated with heart failure is a frequent condition, which may lead to heart function deterioration by the activation of neuro-hormonal mechanisms. Therefore, a vicious circle is present in the relationship of heart failure and anemia. The consequence is reflected upon the patients' survival, quality of life, and hospital readmissions. Anemia and iron deficiency should be correctly diagnosed and treated in patients with heart failure. The etiology is multifactorial but certainly not fully understood. There is data suggesting that the following factors can cause anemia alone or in combination: iron deficiency, inflammation, erythropoietin levels, prescribed medication, hemodilution, and medullar dysfunction. There is data suggesting the association among iron deficiency, inflammation, erythropoietin levels, prescribed medication, hemodilution, and medullar dysfunction. The main pathophysiologic mechanisms, with the strongest evidence-based medicine data, are iron deficiency and inflammation. In clinical practice, the etiology of anemia needs thorough evaluation for determining the best possible therapeutic course. In this context, we must correctly treat the patients' diseases; according with the current guidelines we have now only one intravenous iron drug. This paper is focused on data about anemia in heart failure, from prevalence to optimal treatment, controversies, and challenges.
与心力衰竭相关的贫血是一种常见病症，它可能通过激活神经激素机制导致心脏功能恶化。因此，心力衰竭与贫血之间存在恶性循环。其后果反映在患者的生存率、生活质量和再次入院率上。心力衰竭患者的贫血和缺铁应得到正确诊断和治疗。其病因是多因素的，但尚未完全明确。有数据表明，以下因素可单独或共同导致贫血：缺铁、炎症、促红细胞生成素水平、所服用药物、血液稀释和骨髓功能障碍。有数据表明缺铁、炎症、促红细胞生成素水平、所服用药物、血液稀释和骨髓功能障碍之间存在关联。有最有力循证医学数据支持的主要病理生理机制是缺铁和炎症。在临床实践中，贫血的病因需要进行全面评估，以确定最佳治疗方案。在此背景下，我们必须正确治疗患者的疾病；根据当前指南，我们目前只有一种静脉铁剂药物。本文重点关注心力衰竭中贫血的数据，从患病率到最佳治疗方法、争议和挑战。
