Clinical-Laboratory and Echocardiographic Indicators in Patients with Chronic Heart Failure and Anemic Syndrome

Anemia is one of the serious complications of chronic heart failure (CHF) and is associated with an increased risk of mortality and high hospitalization rates. The purpose of the study was to estimate the clinical-laboratory and echocardiographic indicators in patients with chronic heart failure and anemic syndrome. Materials and methods. This study involved 150 male patients aged 35-78 years (median 58 years) diagnosed with chronic heart failure (CHF) on the background of coronary heart disease (stable angina and prior myocardial infarction). IHD diagnosis was made based on exercise testing, coronary angiography, electrocardiography, echocardiography. The diagnosis of anemia was confirmed at the concentration of hemoglobin less than 110 g/l. General clinical examinations, laboratory (integral indices of endogenous intoxication, bilirubin, aspartate aminotransferase, alanine aminotransferase, urea, creatinine) and echocardiographic (left ventricular ejection fraction, heart chambers in diastole, left ventricular hypertrophy and geometric remodeling: normal, concentric remodeling, concentric hypertrophy, eccentric hypertrophy) investigations were performed. Statistical analysis was done using Statistica for Windows 5.0 program. Data are presented as the median [lower-upper quartiles], comparisons between groups were made using the Mann-Whitney U-test. Categorical data were assessed using the Fisher exact test, the correlation between variables – by Kendall's correlation test. Results. Patients were divided into two groups: group 1 – 40 (27%) patients with CHF and anemic syndrome and group 2 – 110 (73%) patients with CHF without anemic syndrome. It was estimated, that the patients of two groups did not differ significantly in age, presence of any arrhythmia, previous Q-infarction, diabetes mellitus, obesity. According to correlation analysis results a significant correlation has been found between hemoglobin and indices of endogenous intoxication: leukocyte index of intoxication (τ=-0,13; р=0,03), leukocyte shift index (τ=-0,15; р=0,01), aspartate aminotransferase (τ=-0,31; р<0,005), alanine aminotransferase (τ=-0,28; р<0,005); between hemoglobin and left ventricular ejection fraction (τ=0,16, р=0,007), left ventricle end-diastolic diameter (τ=-0,14, р=0,02), left ventricular mass index (τ=0,12; р=0,03). Significantly (р<0,05) higher level of endogenous intoxication (leukocyte index of intoxication, leukocyte shift index, aspartate aminotransferase, alanine aminotransferase), lower values of left ventricular ejection and tendency (р<0,1) for higher values of left ventricle end-diastolic diameter, left ventricular mass index have been found in patients with CHF and anemic syndrome compared without anemic syndrome. Conclusions. The presence of anemia syndrome in patients with CHF is associated with higher indices of endogenous intoxication, with systolic dysfunction and left ventricular dilatation, predominance of eccentric dilated hypertrophy and decreased left ventricular mass index, which is important to consider in diagnostic process and treatment.