Authors
Demyanenko N.Yu.1, Bogdanov A.N.1, Kachnov V.A.1, Maxim O.V.1, Koroleva M.I.2, Shapovalov D.S.1, Ignatenko N.M.1
1 S.M. Kirov Military Medical Academy, St. Petersburg
2 Consultation-diagnosctical center №1, St. Petersburg
Abstract
Ferrum deficiency is one of the most common causes of anemia syndrome, it is a common comorbid age–associated pathology in clinical practice. Clinical manifestations of anemia are known, but latent ferrum deficiency can also negatively affect the clinical picture, aggravating the manifestations of the main pathological process. The negative role of tissue ferrum deficiency on cardiomyocyte metabolism is undeniable. Depending on the mechanism of pathological changes at the tissue and cellular level, there are three different variants of iron deficiency heart failure. The need to correct ferrum deficiency has already been noted in clinical guidelines for the treatment of chronic heart failure, which indicates the clinical significance of this problem for cardiac patients. However, there are few research on the effects of ferrum deficiency on other cardiovascular diseases. The study of the pathogenetic mechanisms of the linkage between ferrum deficiency conditions and such a common pathology as arrhythmias may contribute to changing the management tactics of cardiac patients in order to improve clinical outcomes.
Keywords: anemia syndrome, iron deficiency, arrhythmias, chronic heart failure.
References
1. D, Bogdanov AN, SHCHerbak SG, Lapin SV, Budkova AI. Osobennosti anemii i ferrokinetiki u bol’nyh pozhilogo i starcheskogo vozrasta v zavisimosti ot vyrazhennosti serdechnoj nedostatochnosti i narusheniya funkcii pochek. Universitetskij terapevticheskij vestnik. 2024; 6(2): 140-149. (In Russ.) doi: 10.56871/UTJ.2024.41.60.015.
2. Bogdanov AN, Voloshin SV, Lapin SV, Kustovskij NV, Bedrina NV. 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.
3. Packer M, Anker SD, Butler J, et al. Identification of three mechanistic pathways for iron-deficient heart failure. European Heart Journal. 2024; 45(26): 2281-2293. doi: 10.1093/eurheartj/ehae284.
4. Kachnov VA, Tyrenko VV, Bratilova ES, Koltsov AV. Iron deficiency, anemia and atrial fibrillation. Meditsinskiy sovet. 2024; 6: 260-266. (In Russ.) doi: 10.21518/ms2024-001.
5. Valeev MKh, Khasanov NR. Association of iron deficiency with atrial fibrillation recurrence after pharmacological cardioversion. Russian Journal of Cardiology. 2023; 28(2S): 53–69. (In Russ.) doi: 10.15829/1560-4071-2023-5369.
6. Arakelyan MG, Bockeria LA, Vasilieva EYu, et al. 2020 Clinical guidelines for Atrial fibrillation and atrial flutter. Russian Journal of Cardiology. 2021; 26(7): 4594. (In Russ.) doi: 10.15829/1560-4071-2021-4594.
7. ZHelezodeficitnaya anemiya. Klinicheskie rekomendacii 2021. [URL] (Accessed 24.09.2024) (In Russ.)
8. McDonagh T, Metra M. 2021 Rekomendacii ESC po diagnostike i lecheniyu ostroj i hronicheskoj serdechnoj nedostatochnosti. Rossijskij kardiologicheskij zhurnal. 2023; 28(1): 5168. (In Russ.) doi: 10.15829/1560-4071-2023-5168.
9. Zeller T, Waldeyer C, Ojeda F, et al. Adverse outcome prediction of iron deficiency in patients with acute coronary syndrome. Biomolecules. 2018; 8(3): 60. doi: 10.3390/biom8030060.
10. Merono O, Cladellas M, Ribas-Barquet N, et al. Iron Deficiency Is a Determinant of Functional Capacity and Health-related Quality of Life 30 Days After an Acute Coronary Syndrome. Rev Esp Cardiol (Engl Ed). 2017; 70; 363-70. doi: 10.1016/j.rec.2016.10.004.
11. Cosentino N, Campodonico J, Pontone G, et al. Iron deficiency in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. International Journal of Cardiology. 2020; 300: 14-9. doi: 10.1016/j.ijcard.2019.07.083.
12. Bogdanov AN, Shcherbak SG, Pavlovich D, Lomonosova EV. Iron metabolism, iron deficiency anemia and cardiorenal anemia syndrome in elderly and old patients. Herald of North-Western State medical University named after I.I. Mechnikov. 2017; 9(4): 46-52 (In Russ.) doi: 10.17816/mechnikov20179446-52.
13. Bogdanov AN, Shcherbak SG, Pavlovic D. Anemias in elderly and old. Herald of North-Western State Medical University named after I.I. Mechnikov. 2018; 10(2): 19-26. (In Russ.) doi: 10.17816/mechnikov201810219-26.
14. Tarasova NA, KHasanov NR. Iron deficiency in patients with cardiovascular diseases. Practical medicine. 2023; 21(2): 15-20. (In Russ.) doi: 10.32000/2072-1757-2023-2-15-20.
15. Smirnova MP, Chizhov PA. Factors associated with iron deficiency in heart failure. Cardiovascular Therapy and Prevention. 2023; 22(2): 3367. (In Russ.) doi: 10.15829/1728-8800-2023-3367.
16. Beattie JM, Khatib R, Phillips CJ, Williams SG. Iron deficiency in 78805 people admitted with heart failure across England: a retrospective cohort study. Open Heart. 2020; 7: 001153. doi: 10.1136/openhrt-2019-001153.
17. Mareev VYu, Begrambekova YuL, Mareev YuV, et al. Iron deficiency in Russia heart failure patients. Observational cross-sectional multicenter study. Kardiologiia. 2022; 62(5): 4-8. (In Russ.) doi: 10.18087/ cardio.2022.5.n2083.
18. Klip IT, Comin-Colet J, Voors AA, et al. Iron deficiency in chronic heart failure: An international pooled analysis. Am Heart J. 2013; 165: 575-582.e3. doi: 10.1016/j.ahj.2013.01.017.
19. Anand IS, Gupta P. Anemia and Iron Deficiency in Heart Failure: Current Concepts and Emerging Therapies. Circulation. 2018; 138(1): 80-98. doi: 10.1161/CIRCULATIONAHA.118.030099.
20. Silverberg DS, Wexler D, Schwartz D. Is Correction of Iron Deficiency a New Addition to the Treatment of the Heart Failure? International Journal of Molecular Sciences. 2015; 16(12): 1405674. doi: 10.3390/ijms160614056.
21. Rizzo C, Carbonara R, Ruggieri R, et al. Iron Deficiency: A New Target for Patients with Heart Failure. Front Cardiovasc Med. 2021; 8: 1-10. doi: 10.3389/fcvm.2021.709872.
22. Vatutin NT, Taradin GG, Kanisheva IV, et al. Anaemia and iron deficiency in chronic heart failure patients. Kardiologiia. 2019; 59(4S): 4-20. (In Russ.) doi: 10.18087/cardio.2638.
23. Musina NN, Saprina TV, Prokhorenko TS, et al. Specifics of inflammation parameters, ferrokinetics and structure of anemic syndrome in patients with diabetes mellitus. Russian Journal of Preventive Medicine. 2020; 23(6): 7280. (In Russ.) doi: 10.17116/profmed20202306272.
24. Stuklov NI. Iron Deficiency and Anemia in Patients with Chronic Heart Failure. 2017; 13(5): 651-60. (In Russ.) doi: 10.20996/1819-6446-2017-13-5-651660.
25. Hadarcev AA, Logatkina AV, Terekhov IV. Vliyanie ingibitora angiotenzinprevrashchayushchego fermenta na koncentraciyu v plazme krovi citokinov i vazoaktivnyh molekul u bol’nyh ishemicheskoj bolezn’yu serdca i arterial’noj gipertoniej. Terapevticheskij arhiv. 2017; 89(12): 97-102. (In Russ.) doi: 10.17116/terarkh2017891297-102.
26. Troshina EA. The role of cytokines in the processes of adaptive integration of immune and neuroendocrine reactions of the human body. Problems of Endocrinology. 2021; 67(2): 4-9. (In Russ.) doi: 10.14341/probl12744.
27. Demihov VG, Zenina MN, Rukavicin OA. Anemii. 2nd ed. M.: GEOTAR-Media, 2016. (In Russ.)
28. Enjuanes C, Bruguera J, Grau M, et al. Iron Status in Chronic Heart Failure: Impact on Symptoms, Functional Class and Submaximal Exercise Capacity. Rev Esp Cardiol (Engl Ed). 2016; 69(3): 247-255. doi: 10.1016/j.rec.2015.08.018.
29. Martens P, Nijst P, Verbrugge FH, et al. Impact of iron deficiency on exercise capacity and outcome in heart failure with reduced, mid-range and preserved ejection fraction. Acta Cardiol. 2018; 73(2): 115-123. doi: 10.1080/00015385.2017.1351239.
30. Núñez J, Comín-Colet J, Miñana G, et al. Iron deficiency and risk of early readmission following a hospitalization for acute heart failure. Eur J Heart Fail. 2016; 18(7): 798-802. doi: 10.1002/ejhf.513.
31. Ponikowski P, van Veldhuisen DJ, Comin-Colet J, et al. Beneficial effects of long-term intravenous iron therapy with ferric carboxymaltose in patients with symptomatic heart failure and iron deficiency. Eur Heart J. 2015; 36: 657-68. doi: 10.1093/eurheartj/ehu385.
32. van Veldhuisen DJ, Ponikowski P, van der Meer P, et al. Effect of ferric carboxymaltose on exercise capacity in patients with chronic heart failure and iron deficiency. Circulation. 2017; 136: 1374-83. doi: 10.1161/CIRCULATIONAHA.117.027497.
33. Drapkina OM, Martynov AI, Baida AP, et al. Resolution of the expert council “Relevant issues of iron deficiency in the Russian Federation”. Cardiovascular Therapy and Prevention. 2020; 19(5): 2700. (In Russ.) doi: 10.15829/1728-8800-2020-2700.
34. Westenbrink BD, Alings M, Granger CB, et al. Anemia is associated with bleeding and mortality, but not stroke, in patients with atrial fibrillation: Insights from the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial. Am Heart J. 2017; 185: 140-149. doi: 10.1016/j.ahj.2016.12.008.
35. Bonde AN, Blanche P, Staerk L, et al. Oral anticoagulation among atrial fibrillation patients with anaemia: an observational cohort study. Eur Heart J. 2019; 40(46): 3782-3790. doi: 10.1093/eurheartj/ehz155.
36. An Y, Ogawa H, Esato M, et al. Cardiovascular Events and Mortality in Patients With Atrial Fibrillation and Anemia (from the Fushimi AF Registry). Am J Cardiol. 2020; 134: 74-82. doi: 10.1016/j.amjcard.202.
37. Tu SJ, Hanna-Rivero N, Elliott AD, et al. Associations of anemia with stroke, bleeding, and mortality in atrial fibrillation: A systematic review and meta-analysis. J Cardiovasc Electrophysiol. 2021; 32(3): 686-694. doi: 10.1111/jce.14898.
38. Hanna-Rivero N, Tu SJ, Elliott AD, et al. Anemia and iron deficiency in patients with atrial fibrillation. BMC Cardiovasc Disord. 2022; 22(1): 204. doi: 10.1186/s12872-022-02633-6.
39. Lee WH, Hsu PC, Chu CY, et al. Anemia as an Independent Predictor of Adverse Cardiac Outcomes in Patients with Atrial Fibrillation. Int J Med Sci. 2015; 12(8): 618-624. doi: 10.7150/ijms.11924.
40. Minhas AMK, Sagheer S, Shekhar R, et al. Trends and Inpatient Outcomes of Primary Atrial Fibrillation Hospitalizations with Underlying Iron Deficiency Anemia: An Analysis of The National Inpatient Sample Database from 2004-2018. Curr Probl Cardiol. 2022; 47(10): 101001. doi: 10.1016/j.cpcardiol.2021.101001.
41. Lim WH, Choi EK, Han KD, et al. Impact of Hemoglobin Levels and Their Dynamic Changes on the Risk of Atrial Fibrillation: A Nationwide Population-Based Study. Sci Rep. 2020; 10(1): 1-8. doi: 10.1038/s41598-020-63878-9.
42. Kim M, Hong M, Kim JY, et al. Clinical relationship between anemia and atrial fibrillation recurrence after catheter ablation without genetic background. Int J Cardiol Heart Vasc. 2020; 27: 100507. doi: 10.1016/j.ijcha.2020.100507.
43. Denisova TP, Cherevatova OM. Anemic syndrome influence on arrhythmia incidence in geriatric patients. Russian Journal of Cardiology. 2006; 4: 20-23. (In Russ.)
44. Shaposhnik II, Genkel VV, Kuznetsova AS, et al. Cardiac arrhythmias in certain interal diseases (review). Sibirskij nauchnyj medicinskij zhurnal. 2019; 39(5): 29-40. (In Russ.) doi: 10.15372/SSMJ20190504.
45. Eremin SA, Sadrieva LI, Salihov IG. Sostoyanie vegetativnoj regulyacii pri narusheniyah ritma serdca. Kazanskij medicinskij zhurnal. 2003; 5. [URL] Accessed: 24.09.2024 (In Russ.)
46. Ustin MA, Zor’kina AV, Horoneko SE. Vliyanie zhelezodeficitnoj anemii na variabel’nost’ serdechnogo ritma. Rossijskij kardiologicheskij zhurnal. 2020; 2. [URL] Accessed: 24.09.2024. (In Russ.)
47. Aksyutina NV, Davydov EL, Kusaev VV, et al. Associaciya anemii s ekstrasistoliej u pacientov so starcheskoj asteniej. Pul’s. 2022; 24(11): 80-86. (In Russ.) doi: 10.26787/nydha-2686-6838-2022-24-11-80-86.
