Anemia in heart failure - from guidelines to controversies and challenges

Özet

Anemia associated with heart failure is a frequent condition, which may lead to heart function deterioration by the activation of neuro-hormonalmechanisms. Therefore, a vicious circle is present in the relationship of heart failure and anemia. The consequence is reflected upon the patients’survival, quality of life, and hospital readmissions. Anemia and iron deficiency should be correctly diagnosed and treated in patients withheart failure. The etiology is multifactorial but certainly not fully understood. There is data suggesting that the following factors can cause anemiaalone or in combination: iron deficiency, inflammation, erythropoietin levels, prescribed medication, hemodilution, and medullar dysfunction.There is data suggesting the association among iron deficiency, inflammation, erythropoietin levels, prescribed medication, hemodilution,and medullar dysfunction. The main pathophysiologic mechanisms, with the strongest evidence-based medicine data, are iron deficiency andinflammation. In clinical practice, the etiology of anemia needs thorough evaluation for determining the best possible therapeutic course. In thiscontext, we must correctly treat the patients’ diseases; according with the current guidelines we have now only one intravenous iron drug. Thispaper is focused on data about anemia in heart failure, from prevalence to optimal treatment, controversies, and challenges.