Vaidya Rudra, Redkar Neelam, Relwani Prakash, Mandaknalli Saurabh Leeladhar, Shah Prasham
Senior Resident, Department of General Medicine, Hinduhridaysamrat Balasaheb Thackeray Medical College and Dr. R. N. Cooper Municipal General Hospital, Mumbai, Maharashtra, India, Corresponding Author, Orcid: https://orcid.org/0009-0008-6912-2176.
Professor and Head of Department, Department of General Medicine, Hinduhridaysamrat Balasaheb Thackeray Medical College and Dr. R. N. Cooper Municipal General Hospital, Mumbai, Maharashtra, India, Orcid: https://orcid.org/0000-0002-7817-6212.
J Assoc Physicians India. 2025 Jun;73(6):18-22. doi: 10.59556/japi.73.1022.
Heart failure (HF) and iron deficiency anemia (IDA) are both common in the elderly, especially in India, and the relative paucity of data about the same makes their relationship worthwhile to study. Also, as IDA, especially nutritional, is relatively simple to manage, it can help in reducing disease burden significantly.
To examine the clinical and etiological profile of patients with HF in the elderly age-group and correlate HF with serum iron, serum ferritin, and percentage transferrin saturation (%TSAT).
The present prospective, observational sectional study was carried out in a tertiary care hospital, for a duration of 1 year. The study population included 138 elderly patients admitted to medicine wards and intensive care unit (ICU) having HF.
Among the 138 patients with HF included in the study [41.30% in the age-group of 61-65 years, 70.29% males, 35.51% having ejection fraction <30%, 47.83% belonging to New York Heart Association (NYHA) class III], the most frequent clinical symptom among the study subjects was breathlessness (98.55). The most frequent clinical sign was basal lung crepitations (93.48%). The most common etiological factor was ischemic heart disease (56.52%). There were higher serum iron levels and serum %TSAT in patients with better ejection fraction as well as better functional class. No significant association was found between hemoglobin levels and ejection fraction or between hemoglobin levels and NYHA class. There were lower serum ferritin levels in patients with better ejection fraction. No significant association was found between serum ferritin levels and NYHA class. Prevalence of ID was found to be 73.19% in the present study. Absolute and functional ID was reported in 48.55% and 24.64% of the subjects, respectively. Absolute or functional ID had the highest prevalence in subjects having ejection fraction <30% and least in subjects having ejection fraction 45-50% and >50%, which was statistically significant. Absolute or functional ID was revealed maximum in NYHA class IV while it was found least in class I.
ID was associated with severe and more symptomatic HF in the elderly. The results highlight that iron supplementation through diet and medicines will help to decrease mortality, morbidity, and financial burden of the healthcare system.
心力衰竭（HF）和缺铁性贫血（IDA）在老年人中都很常见，尤其是在印度，而关于两者关系的数据相对较少，这使得它们之间的关系值得研究。此外，由于IDA，尤其是营养性IDA相对易于管理，它有助于显著减轻疾病负担。
研究老年心力衰竭患者的临床和病因特征，并将心力衰竭与血清铁、血清铁蛋白和转铁蛋白饱和度百分比（%TSAT）相关联。
本前瞻性观察性横断面研究在一家三级护理医院进行，为期1年。研究人群包括138名入住内科病房和重症监护病房（ICU）的老年心力衰竭患者。
在纳入研究的138例心力衰竭患者中[61 - 65岁年龄组占41.30%，男性占70.29%，射血分数<30%的占35.51%，属于纽约心脏协会（NYHA）III级的占47.83%]，研究对象中最常见的临床症状是呼吸困难（98.55%）。最常见的临床体征是双肺底湿啰音（93.48%）。最常见的病因是缺血性心脏病（56.52%）。射血分数较好以及功能分级较好的患者血清铁水平和血清%TSAT较高。血红蛋白水平与射血分数之间或血红蛋白水平与NYHA分级之间未发现显著关联。射血分数较好的患者血清铁蛋白水平较低。血清铁蛋白水平与NYHA分级之间未发现显著关联。在本研究中，ID的患病率为73.19%。分别有48.55%和24.64%的受试者报告有绝对缺铁和功能性缺铁。绝对或功能性缺铁在射血分数<30%的受试者中患病率最高，在射血分数45 - 50%和>50%的受试者中患病率最低，差异具有统计学意义。绝对或功能性缺铁在NYHA IV级中最为明显，而在I级中最少。
ID与老年患者严重且症状更明显的HF相关。结果表明，通过饮食和药物补充铁将有助于降低死亡率、发病率和医疗系统的经济负担。
