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

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 II–IV, 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 μg/L) or ferritin in the range from 100 to 299 μg/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.