Role of Hepcidin and Pro-Inflammatory Cytokines in Chronic Heart Failure in Combination with Anemia

Abstract

Objectives: To study the effect of hepcidin on the course of chronic heart failure with anemia. Methods: 115 patients with CHF caused by ischemic heart disease (IHD) were chosen. All of them were treated in in-patient conditions and were followed in out-patient conditions. The patients were divided into two main and one control groups. Main group A consisted of 40 CHF patients with iron deficiency anemia. Main group B consisted of 35 CHF patients with anemia of chronic disease. 40 CHF patients without anemia were chosen for the control group. To patients of the main groups 200mg of Iron (III) hydroxide (Venofer®) was administered intravenously once in two days, along with standard CHF treatment. Results: Our study found reliable increase of serum levels hepcidin in CHF patients with anemia of chronic disease compared to CHF patients with iron deficiency anemia (45,4%) and control group (33%) (P\u3c0,001). This, in turn, shows that hepcidin is an important indicator in differential diagnosis between anemia of chronic disease and iron deficiency anemia. Statistical analysis of pro-inflammatory cytokines and hepcidin levels was done in order to find any associations in patients of our study. Following was found: in group B weak positive correlation between hepcidin and IL-1 (r=0,24 Р\u3c0,05), strong positive correlation between hepcidin and IL-6 (r=0,52, Р\u3c0,001), and moderate positive correlation between hepcidin and TNF-α (r=0,37, Р\u3c0,05). Conclusion: In CHF patients with anemia of chronic disease (Group B) hepcidin levels were reliably higher than normal ranges and correlation between pro-inflammatory cytokines and hepcidin during deterioration of the disease

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