Rynchak P. Erythropoietin, iron metabolism and cytokines in cases of anemia in patients with chronic heart failure.

Dissertation is devoted to study of a topical problem - concretization of anemic syndrome structure, iron deficiency role in disturbances of clinic-homodynamic status and life quality, relation of ferritin and erythropoietin metabolism disturbances with mediators of nonspecific inflammation (TNF-?, ІL-1?) according to progression of chronic heart failure (CHF) and severity of anemia and therapy optimization. Clinic-pathogenetic investigation of anemia in CHF was performed in 120 patients. Anemia was found in 42,8 % of patients with CHF of ischemic genesis, after the accompanying diseases that can cause were eliminated, anemia as a result of CHF was found in 23,9%. In patients with CHF with increasing of clinical symptoms of CHF the levels of hemoglobin, hematokrit, and serum iron were decreasing. In pathogenetic structure there was a combination of anemia of chronic disease (ACD) and iron deficiency anemia (IDA). The level of erythropoietin was increasing according to severity of CHF, the levels of ferritin was high not depending on the FC of CHF. In II, III, IV FC of CHF with anemia there were significant higher levels of TNF-?, ІL-1? more expressed myocardial remodeling, tolerance to physical exertion, life quality then in patients with CHF without anemia. With increasing severity of anemic syndrome there was a progressing of pathological myocardial remodeling, tolerance to physical exertion and quality life became worse. Iron drugs and quercetine allowed to significally increase the dynamics of hemogramme, ferritin, erythropoietin, TNF- ?, ІL-1?, clinic-functional datas comparing to the patients which were talking only ferrotherapy.