Iron deficiency and anemia in patients with chronic heart failure

Problems of iron deficiency and anemia in chronic heart failure (CHF) are discussed in the article. A review of the literature on the epidemiology, etiology and pathogenesis of anemia in this category of patients is presented. Various published data on the effect of anemia on the prognosis of CHF are given. The role of iron deficiency in the development of anemia, the features of its diagnosis and influence on the course of CHF are discussed. The author explains the role of various iron deficiency syndromes in the development of anemia in CHF, suggests a significant predominance of mixed forms of iron deficiency, such as iron deficiency anemia in combination with anemia of chronic disease, which are associated not so much with absolute iron deficiency as with systemic inflammatory response. All the existing approaches to the treatment of iron deficiency and anemia in patients with CHF are presented. The positive and negative results of the use of classical oral iron preparations, intravenous forms, isolated and combined use of recombinant human erythropoietin are presented. The author discusses the reasons for the failure in the treatment of anemia and the absence of a pronounced effect on the clinical manifestations of CHF in the application of standard approaches in treatment. As a possibility of more effective correction of iron deficiency and anemia in patients with CHF, new preparations of liposomial (sucrosomial) iron for oral administration are offered. The last extremely encouraging clinical results of the use of a new iron formulation in the treatment of iron deficiency and anemia in this group of patients are given.