Association Of Iron Studies With Serum Brain Natriuretic Peptide Level In Heart Failure Patients- A One Year Hospital Based Cross Sectional Study

Abstract

Background and Objectives Iron deficiency plays a critical role in the anaemia of CHF, and it can contribute to EPO resistance, as the bone marrow will not respond to EPO unless adequate iron stores are present. There is increasing volume of literature on high prevalence of anemia in heart failure patients and strong association between Iron metabolism and deterioration in heart function but studies linking Iron metabolism parameters with serum proBNP are scarce. This study was conducted to find an association between iron studies and BNP levels in heart failure with reduced ejection fraction patients. Methodology A total of 93 consecutive patients presenting with Heart failure with reduced ejection fraction (HFrEF) were studied. Iron studies (Sr. Iron, Sr.TIBC, Sr. Ferritin, TSAT %), hemoglobin (Hb), serum creatinine, 2D echocardiography were done and then were compared with serum proBNP levels. Results Majority of the subjects with heart failure were aged between 61 to 70 years in the study, with male preponderance. Among the study population majority of 78.49% subjects had Iron deficiency (ID) .66.66% had ID with anemia and 11.82% had ID without anaemia. It was also noticed that serum proBNP had a significant linear negative correlation with Sr. Iron, moderate positive correlation with serum TIBC, a moderate negative correlation with TSAT% but a weak positive correlation with Serum ferritin levels. We also noticed that patients who had left ventricular ejection fraction(LVEF) below ≤45% had a significant positive correlation with Hemoglobin, a moderate positive correlation with Serum iron but a weak positive correlation with Serum TIBC and weak negative correlation with serum Ferritin levels. Conclusion Our study showed that patients diagnosed with HFrEF for > 6 months had a 78.49% prevalence of iron deficiency with or without anaemia. Also iron deficiency had a statistically significant linear correlation with serum proBNP, Hb and LVEF