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Soluble TNFα receptor Type I and Hepcidin as determinants of development of anemia in the long-term follow-up of heart failure patients.
MedLine Citation:
PMID:  22609894     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Anemia is common in patients with chronic heart failure (CHF) and is associated with a worse prognosis. This study aims to identify the biological mechanisms which reflect evolutionary changes in the hemoglobin concentrations in heart failure patients who are still not anaemic. METHODS: Fifty-nine patients (54±14years, 83% males) with CHF (LVEF 28±10%), who did not have anemia, and had not received any previous transfusions, were included. The parameters studied were: iron metabolism (ferritin, iron, transferrin, soluble transferrin receptor (sTfR), hepcidin); inflammation (C-reactive protein, soluble TNFα receptor I (sTNFRI), interleukin 6); and myocardial stress (NT-proBNP, high sensitivity TnT, growth differentiation factor 15). All parameters were measured on inclusion and one year after inclusion. RESULTS: Baseline hemoglobin (g/dl) was 14.7±1.5 and at one year of follow-up it showed a significant decrease of -0.4 (RIC: -0.7 to -0.06) (p=0.02). At baseline, only the sTNFRI was a predictor of a decrease in hemoglobin one year later (p=0.007). During follow-up, the increase in sTNFRI (p=0.002, r=-0.39) and hepcidin (p=0.006, r=-0.35) were both associated with a decrease in hemoglobin. Similarly, the patients who became anemic (13%) had higher levels of hepcidin (p=0.001) and sTNFRI (p=0.008). The remaining parameters did not show any relationship with the evolution in the hemoglobin. CONCLUSIONS: In CHF patients without anemia, the increase in the inflammatory state (sTNFRI) and the following deterioration in the iron metabolism (hepcidin), were the main determinants of a decrease in hemoglobin and the appearance of anemia in the long term follow-up period.
Authors:
A Martínez-Ruiz; P L Tornel-Osorio; J Sánchez-Más; J Pérez-Fornieles; J A Vílchez; P Martínez-Hernández; D A Pascual-Figal
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-5-17
Journal Detail:
Title:  Clinical biochemistry     Volume:  -     ISSN:  1873-2933     ISO Abbreviation:  -     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-5-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0133660     Medline TA:  Clin Biochem     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012. Published by Elsevier Inc.
Affiliation:
Clinical Analysis Department, Virgen de la Arrixaca University Hospital, Murcia (Spain).
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