Depression, anxiety and asthenia in patients with comorbidity of chronic heart failure and iron deficiency

M. Smirnova, P. Chizhov, A. A. Baranov
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Abstract

BACKGROUND: A common comorbid pathology in patients with chronic heart failure is iron deficiency, as well as depressive and anxiety disorders. AIM: To study the frequency and severity of depression, anxiety and asthenia in patients with heart failure and iron deficiency. MATERIALS AND METHODS: 290 patients, 78 men and 212 women (mean age 71.29 8.11 years) with chronic heart failure, functional class IIIV, have been examined. All the patients underwent clinical examination, a 6-minute walk test; a general blood test, the level of NT-proBNP, iron, transferrin, and ferritin in blood serum have been studied; the percentage of transferrin saturation with iron has been calculated. The presence of iron deficiency has been diagnosed on the basis of the following criteria: a decrease in the level of serum ferritin (less than 100 g/L) or ferritin in the range from 100 to 299 g/L and saturation of transferrin with iron less than 20 %. Hospital anxiety and depression scale (HADS) has been used to determine the presence and severity of depression and anxiety in points; the presence and severity of asthenia have been evaluated according to MFI-20 asthenia scale. RESULTS: It has been found that in patients with chronic heart failure and iron deficiency, depression and anxiety are diagnosed significantly more often than in patients without iron deficiency. In addition, in patients with iron deficiency, the severity of depression, anxiety and various manifestations of asthenia are significantly greater. CONCLUSIONS: In chronic heart failure, iron deficiency predisposes patients to the development of depression and anxiety and an increase in various manifestations of asthenia.
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慢性心力衰竭伴缺铁患者的抑郁、焦虑和虚弱
背景:慢性心力衰竭患者常见的共病病理是缺铁,以及抑郁和焦虑障碍。目的:探讨心力衰竭伴缺铁患者抑郁、焦虑、乏力的发生频率及严重程度。材料和方法:290例慢性心力衰竭患者,78名男性和212名女性(平均年龄71.29 - 8.11岁),功能等级为IIIV级。所有患者均接受临床检查,6分钟步行测试;常规血检,研究血清NT-proBNP、铁、转铁蛋白、铁蛋白水平;计算了铁饱和转铁蛋白的百分比。铁缺乏的诊断依据如下:血清铁蛋白水平下降(低于100g /L)或铁蛋白水平在100 - 299 g/L之间,铁转移蛋白饱和度低于20%。医院焦虑抑郁量表(HADS)被用来确定抑郁和焦虑在各点的存在和严重程度;根据MFI-20衰弱量表评估虚弱的存在和严重程度。结果:研究发现,慢性心力衰竭伴缺铁患者中,抑郁和焦虑的诊断明显高于无缺铁患者。此外,缺铁患者抑郁、焦虑及各种虚虚表现的严重程度明显更大。结论:在慢性心力衰竭中,缺铁易使患者出现抑郁和焦虑,并增加各种虚弱表现。
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