Aim. To establish the factors associated with iron deficiency (ID) in pa- tients with heart failure (HF).Material and methods. We examined 294 patients with NYHA class II-IV HF as follows: 213 — with ID, 81 — without ID. All patients underwent a clinical examination, collection of medical history taking into account the presence, duration and severity of comorbidities, drug history, echocardiography, complete blood count, serum iron, ferritin, transferrin, transferrin saturation, soluble transferrin receptors, hepcidin, erythropoietin, and routine laboratory tests. In addition, we determined the presence and severity of asthenia, anxiety, and depression.Results. Twenty-nine clinical, laboratory and echocardiographic parameters were established, which had significant differences in patients with and without ID and significant correlations with ID. Determining the odds ratio for these 29 parameters revealed 7 factors significantly associated with ID in patients with HF. Using multivariate logistic regression, a significant cumulative effect of these factors on the ID risk was established.Conclusion. ID in patients with HF is associated with age, class II-IV HF, elevated hepcidin levels, duration of hypertension and diabetes, history of using angiotensin-converting enzyme inhibitors and novel oral anticoagulants for >1 year.

Relevance. The frequency of chronic heart failure (CHF) increases with age. A common pathology in patients with CHF is iron deficiency (ID). Age may contribute to development of ID in patients with CHF. The purpose of the study: To study the features of clinical and laboratory parameters in elderly and senile patients with CHF, depending on the presence of ID. Materials and methods: 2 groups of patients with CHF 2-4 functional class were examined: group 1-60-74 years (146 patients, mean age 68.1±3.1), group 2-75 years and older (127 patients, mean age 78.3±2.2). All patients underwent a clinical examination, a 6-minute walk test, a general blood test, the determination of the level of iron, ferritin, transferrin in blood serum, iron saturation of transferrin, soluble transferrin receptors, hepcidin, interleukin-6, C-reactive protein, the presence and severity of asthenia, anxiety, depression. Results. It has been established that patients in the senile group have a significantly higher functional life expectancy and more pronounced clinical and laboratory manifestations of CHF (the worst 6-minute walk test, more pronounced manifestations of asthenia and depression, a higher concentration of NT-proBNP, hepcidin), compared with elderly patients. The presence of ID in both age groups increases the manifestations of physical asthenia and anxiety. Conclusions: 1) the severity of clinical manifestations of CHF in senile patients is significantly higher than in elderly patients; 2) in senile patients, the levels of hepcidin and latent ID are significantly higher than those in elderly patients; 3) latent ID in both age groups increases the manifestations of physical asthenia and anxiety; 4) it is advisable to conduct early diagnosis of latent ID in all patients with CHF of elderly and, especially, senile age for the timely detection of this condition and the appointment of therapy for correcting ID.

Iron deficiency is a frequent comorbid condition in patients with chronic heart failure. At the same time, the factors contributing to iron deficiency in these patients are poorly understood.

Контакты: Петр Александрович Чижов p_a_chizhov@rambler.ruСопоставлялось содержание антител к нативной ДНК, ревматоидного фактора, антител к кардиолипину типа IgG и IgM, свободного и белковосвязанного оксипролина в крови лиц с различными дисплазиями сердца и без дисплазий сердца при наличии и отсутствии синдрома вегетативной дисфункции. Выявлены различия этих показателей в исследуемых группах.Ключевые слова: соединительнотканные дисплазии сердца, пролапс митрального клапана, синдром вегетативной дисфункции, иммунологические показатели, обмен оксипролина Contact: Petr Aleksandrovich Chizhov p_a_chizhov@rambler.ruThe blood levels of native DNA antibodies, rheumatoid factor, IgG and IgM cardiolipin antibodies, and free and protein-bound oxyproline were compared in subjects with and without various cardiac dysplasias in the presence and absence of autonomic dysfunction. There were differences in these parameters between the study groups.

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