Authors
Demyanenko N.Yu., Kachnov V.A., Polyakov A.S., Maksim О.V., Ignatenko N.M., Shapovalov D.S.
S.M. Kirov Military medical academy, St. Petersburg
Abstract
The widespread of ferrum deficiency in the population of age-related patients significantly worsens the distance prognosis of major cardiovascular diseases and requires timely diagnosis and correction. The currently accepted routine approach to the diagnosis of latent and apparent ferrum deficiency does not correlate with tissue metabolic changes in cardiomyocytes and needs to be revised. The process of the aggravating effect of anemic syndrome on the course of somatic pathology, including at the tissue level, continue to be actively researched.
Many experimental researches have confirmed that in order to verify ferrum deficiency in cardiomyocytes, in addition to ferritin and ferrum levels in blood serum, it is necessary to calculate the transferrin saturation coefficient with ferrum, assess the level of soluble transferrin receptors and determine the level of hepcidin.
Keywords: tissue ferrum deficiency, anemia syndrome, arrhythmia, laboratory diagnostics.
References
1. Vinogradova NG, Chesnikova AI. Iron deficiency states in cardiovascular diseases: impact on prognosis and features of correction. South Russian Journal of Therapeutic Practice. 2023; 4(1): 7-18. (In Russ.) doi: 10.21886/2712-8156-2023-4-1-7-18.
2. Bogdanov AN, Voloshin SV, Tyrenko VV, Polyakov AS. Iron Deficiency Anemia In Elderly And Senile Patients. Uspekhi gerontologii. 2020; 33(6): 1150-1157. (In Russ.) doi: 10.34922/AE.2020.33.6.018.
3. Kovalev AV, Tishko VV, Polyakov AS, et al. Obosnovanie i vybor optimal’nyh doz peroral’nogo zheleza pri terapii latentnogo deficita zheleza u zhenshchin molodogo vozrasta. Gematologiya Transfuziologiya Vostochnaya Evropa. 2024; 10(1). (In Russ.) doi: 10.34883/PI.2024.10.1.008.
4. Al-Naseem A, Sallam A, Choudhury S, et al. Iron deficiency without anaemia: A diagnosis that matters. Clin Med J R Coll Physicians London. 2021; 21(2): 107-13. doi: 10.7861/CLINMED.2020-0582.
5. Khastieva DR, Khasanov NR. Iron deficiency in patients with coronary artery disease. Russian Journal of Cardiology. 2023; 21(2): 15-20. (In Russ.) doi: 10.15829/1560-4071-2022-4962.
6. Khastieva DR, Malkova MI, Zakirova EB, Zakirova II, et. al. Rationale and design of the open-label, prospective, randomized study of the efficacy of intravenous versus oral iron deficiency therapy in improving left ventricular systolic function in patients with myocardial infarction (OPERA-MI). Russian Journal of Cardiology. 2022; 27(2S): 4961. (In Russ.) doi: 10.15829/1560-4071-2022-4961.
7. Bogdanov AN, Voloshin SV, Lapin SV, Kustovskij NV, Bedrina NS. Diagnostika i lechenie deficita zheleza v pozhilom vozraste. Universitetskij terapevticheskij vestnik. 2023; 5(3): 50-58. (In Russ.) doi: 10.56871/UTJ.2023.32.53.005.
8. Orlov YuP, Govorova NV, Lukach VN, et al. Iron metabolism in conditions of infection. Review. Annals of critical care. 2020; 1: 90-9. (In Russ.) doi: 10.21320/ 1818– 474X-2020-1-90-99.
9. Wofford J, Chakrabarti M, Lindahl PA. Mössbauer spectra of mouse hearts reveal age- dependent changes in mitochondrial and ferritin iron levels. J Biol Chem. 2017; 292: 5546-54. doi: 10.1074/jbc.M117.777201.
10. Dong F, Zhang X, Culver B, Chew HG Jr, Kelley RO, Ren J. Dietary iron deficiency induces ventricular dilation, mitochondrial ultrastructural aberrations and cytochrome c release: involvement of nitric oxide synthase and protein tyrosine nitration. Clin Sci (Lond). 2005; 109(3): 277-286. doi: 10.1042/CS20040278.
11. Blayney L, Bailey-Wood R, Jacobs A, Henderson A, Muir J. The effects of iron deficiency on the respiratory function and cytochrome content of rat heart mitochondria. Circ Res. 1976; 39(5): 744-748. doi: 10.1161/ 01.res.39.5.744.
12. Kobak KA, Radwańska M, Dzięgała M, Kasztura M, Josiak K, Banasiak W, et al. Structural and functional abnormalities in iron-depleted heart. Heart Fail Rev. 2019; 24(2): 269-277. doi: 10.1007/s10741-018-9738-4.
13. Kasztura M, Dzięgała M, Kobak K, et al. Both iron excess and iron depletion impair viability of rat H9C2 cardiomyocytes and L6G8C5 myocytes. Kardiol Pol. 2017; 75: 267-75. doi: 10.5603/KP.a2016.0155.
14. Toblli JE, Cao G, Rivas C, Giani JF, Dominici FP. Intravenous iron sucrose reverses anemia-induced cardiac remodeling, prevents myocardial fibrosis, and improves cardiac function by attenuating oxidative/nitrosative stress and inflammation. Int J Cardiol. 2016; 212: 84-91. doi: 10.1016/j.ijcard. 2016.03.039.
15. Medeiros DM, Beard JL. Dietary iron deficiency results in cardiac eccentric hypertrophy in rats. Proc Soc Exp Biol Med. 1998; 218(4): 370-375. doi: 10.3181/00379727-218-44306.
16. Petering DH, Stemmer KL, Lyman S, Krezoski S, Petering HG. Iron deficiency in growing male rats: a cause of development of cardiomyopathy. Ann Nutr Metab. 1990; 34(4): 232-243. doi: 10.1159/000177592.
17. Bockeria OL, Akhobekov AA. Ion channels and their role in the development of arrhythmias. Annaly aritmologii. 2014; 11(3): 176-184. (In Russ.) doi: 10.15275/annaritmol.2014.3.6.
18. Mel’nikov K.N., A.I. Vislobokov, M.E Kolpakova, Borisova V.A., Ignatov YU.D. Kalievye ionnye kanaly kletochnyh membran / K.N. Mel’nikov, A.I. Vislobokov, M.E. Kolpakova et al. Obzory po klinicheskoj farmakologii i lekarstvennoj terapii. 2009;7(1):3-27. (In Russ.)
19. Zefirov A.L. Ionnye kanaly vozbudimoj kletki (struktura, funkciya, patologiya). Kazan’: Art-kafe, 2010: 270р. (In Russ.)
20. Prozialeck WC, Edwards JR, Woods JM. The vascular endothelium as a target of cadmium toxicity. Life Sci. 2006; 79(16): 1493-1506. doi: 10.1016/j.lfs.2006.05.007.
21. Li W, Coates T, Wood JC. Atrial dysfunction as a marker of iron cardiotoxicity in thalassemia major. Haematologica. 2008; 93(2): 311-312. doi: 10.3324/haematol.11958.
22. Masironi R. Trace Elements and Cardiovascular Diseases. Occup. Environ. Med. 2007; 47(12): 776-780.
23. Wei ZL, Rui YK, Shen L. Effects of hair dyeing on the heavy metals content in hair. Spectroscop. and Spectral Anal. 2008; 28(9): 2187-8 (In Chin.)
24. Doshchicin VL. Rukovodstvo po prakticheskoj elektrokardiografii. M.: MEDpress. 2015: 416. (In Russ.)
25. Fiziologiya cheloveka. .M. Pokrovskiy, G.F. Korot’ko, editors. M., 2003. 656р. (In Russ.)
26. Reshetnyak OA. Korrelyacionnye svyazi mezhdu soderzhaniem kadmiya, kaliya i kal’ciya v organizme i pokazatelyami serdechno- sosudistoj sistemy sportsmenov. Pedagogika, psihologiya i mediko-biologicheskie problemy fizicheskogo vospitaniya i sporta. 2013; 10: 68-72. (In Russ.)
27. Núñez J, Domínguez E, Ramón JM, et al. Iron deficiency and functional capacity in patients with advanced heart failure with preserved ejection fraction. Int J Cardiol. 2016; 207: 365-7. doi: 10.1016/j.ijcard.2016.01.187.
28. Huang C, Chang C, Kuo C, et al. Serum Iron Concentration, but Not Hemoglobin, Correlates with TIMI Risk Score and 6-Month Left Ventricular Performance after Primary Angioplasty for Acute Myocardial Infarction. PLOS ONE. 2014; 9(8): e104495. doi: 10.1371/ journal.pone.0104495.
29. Hovasova NO, Laryushkina ED. Zhelezodeficitnaya anemiya i latentnyj deficit zheleza v praktike terapevta: diagnostika i lechenie. Ambulatornyj priem. 2015; 1: 6-9. (In Russ.)
30. Vdovichenko VP, Borisenok OA, Bronskaya GM. Rasprostranennost’ i klinicheskaya znachimost’ deficita zheleza v praktike terapevta. Medicinskie novosti. 2019; 9. (In Russ.)
31. Polyakova OA, Klepikova MV, Litvinova SN, Isaakyan YUA, Ostroumova OD. Problema deficita zheleza i zhelezodeficitnoj anemii v obshchemedicinskoj praktike. Profilakticheskaya medicina. 2022; 25(12): 127-134 (In Russ.) doi: 10.17116/profmed202225121127.
32. Garganeeva AA, Tukish OV, Kuzheleva EA, Fediunina VA, Kozlov BN. Iron deficiency in cardiac surgery patients and the possibility of its correction at the preoperative stage. Kardiologiia. 2023; 63(7): 68-76 (In Russ.)
33. Baranov II, Sal’nikova IA, Nesterova LA. Clinical practice guidelines for the diagnosis and treatment of iron deficiency: the view from 2022. Akusherstvo i ginekologiya: novosti, mneniya, obuchenie. 2022; 10(2): 56-64 (In Russ.) doi: 10.33029/ 2303-9698-2022-10-2-56-64.