Crucial approaches to diagnostics and anaemia treatment in pregnant women with heart failure at the extragenital pathology clinic

Yuliya Vladimirovna Davydova, K. G. Apresova, А. А. Ogorodnik, А. N. Mokrik, A. Yu. Limanskaya, L. P. Butenko, A. V. Pashynnyi

Abstract


According to modern concepts, aneamia can be a cause of chronic heart failure (CHF) and its result. According to diff erent sources aneamia of chronic disease is the most frequent among patients with the CHF and it is observed in cases of over than 50% patients.
There can be no doubt that combination of aneamia and heart failurein pregnant aggravates the outcomes, increases a risk of severe «cardiac events», and perinatal complications. Overlap of aneamia and heart failure can cause a high risk of fetus growth inhibition, prematurity, a low-birth-weight infant.
According to the foregoing we proved the following examination algorithm for pregnant women with congenital heart diseases of various ethiology and NYHA II–III heart failure.
1. Clinical blood test (reduction in a haemoglobin level below the standard by trimesters – treatment of aneamia). If the heamoglobin level remains within normal limits for a certain trimester but there have been observed signs of apparent heart failure, disorders of life qualities (dyspnea, undue fatiguability, cardiac pains), then the algorithm provides the following examination:
2. C-reactive protein (avoidance of the active phase of the infl ammatory process).
3. Ferritin.
4. Transferrin saturation.
5. Brain natriuretic peptide.


Keywords


aneamia; pregnancy; heart failure; diagnostics; treatment; Maltofer

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References


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Silverberg DS, Wexler D, Palazzuoli A et al. The anemia of heart failure. // ActaHaematol 2009; 122: 109.

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Szachniewicz J, Petruk-Kowalczyk J, Majda J, Kaczmarek A, Reczuch K, Kalra PR, Piepoli MF, Anker SD, Banasiak W, Ponikowski P Anaemia is an independent predictor of poor outcome in patients with chronic heart failure. Int J Cardiol. 2003; 90: 303–308.

Tanner H, Moschovitis G, Kuster GM, Hullin R, Pfi iff ner D, Hess OM, Mohacsi P The prevalence of anemia in chronic heart failure. // Int J Cardiol.2002; 86: 115–121.

Tang Yi-Da, Katz S Anemia in chronic heart failure. Prevalence, Etiology, Clinical correlates and Treatment options. // Circulation. 2006; 113: 2454–2461.


GOST Style Citations


Deswal A, Petersen NJ, Feldman AM, Young JB, White BG, Mann DL Cytokines and cytokine receptors in advanced heart failure: an analysis of the cytokine database from the Vesnarinone trial (VEST). // Circulation. 2001; 103: 2055–2059.

Ezekowitz JA, McAlister FA, Armstrong PW Anemia is common in heart failure and is associated with poor outcomes: insights from a cohort of 12 065 patients with new-onset heart failure. // Circulation. 2003; 107: 223–225.

He SW, Wang LX The impact of anemia on the prognosis of chronic heart failure: a meta-analysis and systemic review. // Congest Heart Fail 2009; 15: 123.

Ganzevoort W Plasma volume and blood pressure regulation in hypertensive pregnancy // J. Hypertens. – 2004. – Vol. 22. – P. 1235-1242.

Gei AF Cardiac disease and pregnancy/ A.F. Gei, G.D.Hankins // Obstet. Gynecol. Clin.North. Am. – 2001. – Vol. 28. – P. 465 – 512.

Gelson E Cardiac disease in pregnancy: congenital heart disease/ E. Gelson, M. Jhonson,M. Gatzolius et al. // The Obst. and Gynaec. 2007. N 9. P. 15–20.

Globits S Atrial natriuretic peptide release is more dependent on atrial fi lling volume than on filling pressure in chronic congestive heart failure/ S. Globits, H. Frank, B. Pacher et al. // Am. Heart J. – 1998. – N 135. – P. 592–597.

Silverberg DS, Wexler D, Palazzuoli A et al. The anemia of heart failure. // ActaHaematol 2009; 122: 109.

Shah R, Agarwal AK Anemia associated with chronic heart failure: current concepts. // ClinInterv Aging 2013; 8: 111.

Szachniewicz J, Petruk-Kowalczyk J, Majda J, Kaczmarek A, Reczuch K, Kalra PR, Piepoli MF, Anker SD, Banasiak W, Ponikowski P Anaemia is an independent predictor of poor outcome in patients with chronic heart failure. Int J Cardiol. 2003; 90: 303–308.

Tanner H, Moschovitis G, Kuster GM, Hullin R, Pfi iff ner D, Hess OM, Mohacsi P The prevalence of anemia in chronic heart failure. // Int J Cardiol.2002; 86: 115–121.

Tang Yi-Da, Katz S Anemia in chronic heart failure. Prevalence, Etiology, Clinical correlates and Treatment options. // Circulation. 2006; 113: 2454–2461.





DOI: http://dx.doi.org/10.18370/2309-4117.2013.14.32-35

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ISSN 2411-1295 (Online), ISSN 2309-4117 (Print)