부산대학교 도서관

Background: Anemia is an accelerating problem among patients with heart failure. In this study, we investigated whether anemia in heart failure was related to hepcidin level. Methods: Totally 70 patients; 50 patients with heart failure and 20 otherwise healthy subjects with no history of a chronic illness including heart failure as control group, were included in the study. Heart failure was verifi ed by echocardiography in each subject and patients were defi ned as ones with reduced ejection fraction (HFrEF) if EF = 40% and with preserved ejection fraction (HFpEF) if EF 40-50%. Exclusion criteria included presence of kidney failure (serum creatinine level>1.4), history of hemorrhage (gastrointestinal or severe menstrual bleeding), chronic liver disease (ALT>2 folds), hematologic disease, iron replacement therapy or blood transfusion in the past six months, hypothyroidism, autoimmune disease and manifest infection. Results: There was no correlation between hepcidin concentration and age, weight, creatinine, iron, vitamin B12, folate, white blood cell (WBC), platetelet, mean corpuscular volume, ESR, ejection fraction (EF) (p > 0,05). There was a positive correlation between hepcidin level and urea, ferritin, hemoglobin, hematocrite, C-reactive protein (p < 0,05). Hepcidin levels of anemic heart failure patients were signifi cantly lower than the non-anemic heart failure patients (p < 0,05). Conclusions: We found that serum hepcidin level in anemic patients with heart failure was lower than in heart failure patients without anemia. Previously, progression of heart failure was found to be associated with decline in circulating hepcidin and the development of iron defi ciency and low hepcidin level was related to unfavorable out come. We believe that iron defi ency occurs as a result of infl ammatory process in heart failure and therefore hepcidin concentrations decrease as a response. However, long-term follow up studies are needed.