Kazan medical journalKazan medical journal0368-48142587-9359Eco-Vector920210.17816/KMJ2018-617Research ArticleAnemia of chronic diseases in patients with dilated and ischemic cardiomyopathyChepurnayaA NLtaty@mail.ruNikulichevaV ILtaty@mail.ruZagidullinI MLtaty@mail.ruLekhmusT YuLtaty@mail.ruRakhmatullinaA RLtaty@mail.ruDemkinaL SLtaty@mail.ruBashkir State Medical UniversityRepublican clinical hospital named after G.G. Kuvatov0808201899461762403082018Copyright © 2018, Chepurnaya A.N., Nikulicheva V.I., Zagidullin I.M., Lekhmus T.Y., Rakhmatullina A.R., Demkina L.S.2018<p><strong>Aim.</strong> To estimate the effect of anemia of chronic diseases on the processes of cardiovascular system remodeling in patients with dilated cardiomyopathy and ischemic cardiomyopathy.</p>
<p><strong>Methods.</strong> The study included 27 patients with dilated cardiomyopathy with anemia, 19 with dilated cardiomyopathy without anemia, 11 with ischemic cardiomyopathy with anemia, 34 with ischemic cardiomyopathy without anemia, and 30 healthy individuals. In these comparison groups, peripheral blood, mean corpuscular hemoglobin and mean cell hemoglobin concentration, reticulocytes, serum iron and ferritin were examined. Electrocardiography, echocardiography, scintigraphy and coronary angiography were performed.</p>
<p><strong>Results.</strong> In all groups identical signs of chronic heart failure class 3 and 4 were found to be predominant, which was confirmed by a significant decrease of blood pressure, stroke volume, ejection fraction, increase of end systolic and diastolic volumes and sizes, as well as left and right atrial size. Patients with dilated and ischemic cardiomyopathy with anemia had decreased hemoglobin, number of erythrocytes and platelets, positive correlation between hemoglobin and serum iron (r=0.49, p=0.000), red blood cells and ferritin (r=0.61, p=0.000), negative correlation between hemoglobin and ferritin (r=-0.51, p=0.02). In ischemic cardiomyopathy with anemia positive correlation was found between hemoglobin and serum iron (r=0.54, p=0.000), erythrocytes and ferritin (r=0.49, p=0.03), negative correlation - between hemoglobin and ferritin (r=0.54, p=0.03).</p>
<p><strong>Conclusion.</strong> In patients with dilated and ischemic cardiomyopathy no significant effect of anemia of chronic diseases on heart remodeling processes was revealed.</p>dilated cardiomyopathyischemic cardiomyopathyanemia of chronic diseasesдилатационная кардиомиопатияишемическая кардиомиопатияанемия хронических заболеваний[Elliott P., Anderson B., Arbustini E. et al. Classification of the cardiomyopathies: a position statement from the Europlan society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur. Heart J. 2008. 29 (2): 270–276. DOI: 10.1093/eurheartj/ehm342.][Uskach T.M., Kochetov A.G. Clinical and statistical analysis of the prevalence of anemia in patients with chronic heart failure. Kardiologiya. 2011; 51 (1): 11–17. (In Russ.)][Arutyunov A.G., Dragunov D.O., Arutyunov G.P. et al. Major risk factors of patient’s on prognosis in decompensation of heart failure. Kardiologiya. 2014; 54 (12): 37–43. (In Russ.)][Tereshchenko S.N., Zhirov I.V. Analysis of causes of development of anemia in patients with chronic heart failure. Kardiologiya. 2011; 51 (5): 20–26. (In Russ.)][Moiseev O.M., Gudkova A.Ya. Myocardial diseases. In: Kardiologiya. (Cardiology.) Ed. by E.V. Shlyakhto. Moscow: GEOTAR-Media. 2015; 532–558. (In Russ.)][Tereshchenko S.N., Zhirov I.V., Nasanova S.M. What we know about acute decompensation of heart failure. Kardiologiya. 2015; 55 (4): 91–96. (In Russ.)][Chepurnaya A.N., Nikulicheva V.I., Safuanova G.Sh. Hemic cardiomyopathy in patients with iron deficiency anemia. Meditsinskiy vestnik MVD. 2016; (5): 11–16. (In Russ.)][Ganapiev A.A., Moiseeva S.I. Anemia in the background of chronic diseases. In: Gematologiya. (Hematology.) Ed. by S.I. Ryabov. St. Petersburg: SpetsLit. 2011; 147–150. (In Russ.)][Rukovitsyn O.A., Zenina M.N. Anemias. In: Gematologiya. (Hematology.) Ed. by O.A. Rukavitsyn. Moscow: GEOTAR-Media. 2015; 133–157. (In Russ.)][Vorob’ev P.A., Nekrasova N.I. Anemia of chronic diseases. In: Klinicheskaya gematologiya. (Clinical hematology.) Ed. by A.I. Vorob’ev. Vol. 3. Moscow: N’yudiamed. 2005; 313–321. (In Russ.)][Idel’son L.I., Vorob’ev P.A. Iron deficiency anemia. In: Klinicheskaya gematologiya. (Clinical hematology.) Ed. by A.I. Vorob’ev. Vol. 3. Moscow: N’yudiamed. 2005; 171–189. (In Russ.)][Chapurnaja A.N., Nikulicheva V.I., Khamitova K.A. et al. Challenging aspects and role of immunity disorders in pathogenesis of dilated and ischemic cardiopathy. Review and authors finding. Meditsinskiy vestnik Bashkortostana. 2011; (3): 58–64. (In Russ.)][Chapurnaja A.N., Khamitova K.A., Nikulicheva V.I. et al. Peculiaries of producing early inflammatory markers of intercellular adhesive molecules SICAM-1 and SICAM-3 dilatation and ischemic cardiomyopathies. Permskiy meditsinskiy zhurnal. 2011; 31 (2): 73–78. (In Russ.)][Khamitova K.A., Chapurnaya A.N., Nikulicheva V.I., Safuanova G.Sh. Сontent of cytokine inflammatory markersin patients with chronic heart failure caused by cardiomyopathy. Acta biomedica scientifica. 2017; (3): 48–54. (In Russ.)][Kuliba A.N., Bogdanov A.N. Anemia of chronic diseases. In: Klinicheskaya gematologiya. (Clinical hematology.) Ed. by A.N. Bogdanov, V.I. Mazurov. Saint Petersburg: Foliant. 2008; 203–206. (In Russ.)][Weiss G., Goodnaugh L.T. Anemia of chronic disease. New Brit. J. Med. 2005; 352: 1011–1023. DOI: 10.1056/NEJMra041809.][Smorkalova E.V., Aznabaeva L.F., Nikulicheva V.I. et al. The characteristics of iron metabolism under iron-deficiency anemia and chronic disorders anemia. Klinicheskaya laboratornaya diagnostika. 2011; (5): 30–32. (In Russ.)][Fitzsimons E.J., Brock J.H. The anemia of chronic disease. Remains hard to distinguish from iron deficiency anaemia. Brit. Med. J. 2001; 322 (7290): 811–812. DOI: 10.1136/bmj.322.7290.811.][Ezekowits S.A., Alister M.C., Armstrong P.W. Anemia in common in heart failure and is associated with poor outcomes: insights from a cohort of 12,065 patients with new-onset heart failure. Circulation. 2003; 107: 223–225. DOI: 10.1161/01.CIR.0000052622.51963.FC.][Cook J.D. Diagnosis and management of iron-deficiency anaemia. Best Pract. Res. Clin. Haematol. 2005; 18 (2): 319–332. DOI: 10.1016/j.beha.2004.08.022.][Napalkov D.A. Prevalence and structure of anemia in patients with chronic heart failure in a therapeutic hospital. Kardiologiya. 2009; (4): 37–39. (In Russ.)][Na Y.J., Han S.B., Kang J.S. et al. Lactoferrin works as a new LPS-binding protein in inflammatory activation of macrophages. Int. Immun. Pharmacol. 2004; 4: 1187–1199. DOI: 10.1016/j.intimp.2004.05.009.]