EXPLORING THE INTERACTIONS BETWEEN ANEMIA AND HEART FAILURE: A HISTOPATHOLOGICAL AND HEMATOLOGICAL STUDY ON HOW BLOOD ABNORMALITIES INFLUENCE CARDIAC TISSUE DAMAGE
Main Article Content
Keywords
Anemia, Heart Failure, Cardiac Tissue Damage, Blood Abnormalities
Abstract
Introduction: Anemia and heart failure (HF) are two prevalent and interconnected medical conditions that significantly impact global health.
Objective: This study aims to explore the histopathological and hematological interactions between anemia and heart failure, with a focus on how blood abnormalities influence cardiac tissue damage.
Methodology: This prospective, observational study was conducted at Aziz Fatima Medical
and Dental College Faisalabad & CMH Multan Institute of Medical Sciences, Multan from
A total of 88 patients diagnosed with heart failure were recruited from a tertiary care hospital.
Results: Data were collected from 88 patients. The results indicate that patients with severe anemia (n=30) were slightly older (mean age 62.8 years) compared to those with mild-to-moderate anemia (n=58, mean age 62.1 years). Both groups had a similar gender distribution, with approximately 55% males in the mild-to-moderate group and 53% in the severe group. However, patients with severe anemia showed significantly reduced left ventricular ejection fraction (LVEF) at 32% compared to 41% in the mild-to-moderate group, along with a higher prevalence of iron deficiency (80% vs. 55%).
Conclusion: It is concluded that anemia significantly exacerbates cardiac dysfunction and tissue damage in heart failure patients, primarily through mechanisms of chronic hypoxia, inflammation, and iron deficiency. Severe anemia is associated with increased myocardial fibrosis, reduced ejection fraction, and worsened clinical outcomes.
References
2. Mezzetti, E., Costantino, A., Leoni, M., Pieretti, R., Di Paolo, M., Frati, P., Maiese, A., &Fineschi, V. (2023). Autoimmune Heart Disease: A Comprehensive Summary for Forensic Practice. Medicina, 59(8), 1364. https://doi.org/10.3390/medicina59081364
3. Arita, Y.; Nakaoka, Y.; Otsuki, M.; Higuchi, K.; Hashimoto-Kataoka, T.; Yasui, T.; Masaki, T.; Ohtani, T.; Kishimoto, T.; Yamauchi-Takiharo, K.; et al. Cytokine storm after cessation of tocilizumab in a patient with refractory Takayasu arteritis. Int. J. Cardiol. 2015, 187, 319–321.
4. Chung, D.C.; Choi, J.E.; Song, Y.K.; Lim, A.L.; Park, K.H.; Choi, Y.J. Polyarteritis nodosa complicated by chronic total occlusion accompanying aneurysms on all coronary arteries. Korean Circ. J. 2012, 42, 568–570.
5. Chimenti, C.; Alfarano, M.; Toto, F.; Fanisio, F.; Verardo, R.; Galea, N.; Agati, L.; Frustaci, A. Myocarditis and intramural coronary vasculitis in polyarteritis nodosa: An unusual treatable form of heart failure. ESC Heart Fail. 2020, 7, 4357–4360.
6. Pagnoux, C.; Seror, R.; Henegar, C.; Mahr, A.; Cohen, P.; Le Guern, V.; Bienvenu, B.; Mouthon, L.; Guillevin, L.; French Vasculitis Study Group. Clinical features and outcomes in 348 patients with polyarteritis nodosa: A systematic retrospective study of patients diagnosed between 1963 and 2005 and entered into the French Vasculitis Study Group Database. Arthritis Rheum. 2010, 62, 616–626.
7. Howard, T.; Ahmad, K.; Swanson, J.A.; Misra, S. Polyarteritis nodosa. Technol. Vasc. Interv. Radiol. 2014, 17, 247–251.
8. Harada, Y.; Suzuki, T.; Shinagawa, T.; Yoshimoto, T. Cardiac arrest in a patient with polyarteritis nodosa. Intern. Med. 2013, 52, 2759–2763.
9. Peters, B.; Von Spiczak, J.; Ruschitzka, F.; Distler, O.; Manka, R.; Alkadhi, H. Cardiac manifestation of polyarteritis nodosa. Eur. Heart J. 2018, 39, 2603.
10. Plastiras, S.C.; Moutsopoulos, H.M. Arrhythmias and Conduction Disturbances in Autoimmune Rheumatic Disorders. ArrhythmElectrophysiol. Rev. 2021, 10, 17–25.
11. Watanabe, Y.; Sakamoto, K.; Matsukage, S.; Ogimoto, A. Heart failure in a patient with polyarteritis nodosa. Eur. Heart J. 2020, 4, 1–2.
12. Kikuchi, K.; Hoashi, T.; Kanazawa, S.; Tamaki, K. Angiogenic cytokines in serum and cutaneous lesions of patients with polyarteritis nodosa. J. Am. Acad. Dermatol. 2005, 53, 57–61.
13. Caforio, A.L.; Marcolongo, R.; Jahns, R.; Fu, M.; Felix, S.B.; Iliceto, S. Immune-mediated and autoimmune myocarditis: Clinical presentation, diagnosis and management. Heart Fail Rev. 2013, 18, 715–732.
14. Takeishi, M.; Mimori, A.; Adachi, D.; Suzuki, T. [A case of adult polyarteritis nodosa associated with fulminant group A streptococcal infection]. Ryumachi 2002, 42, 682–686.
15. Kalayciyan, A.; Zouboulis, C. An update on Behçet’s disease. J. Eur. Acad. Dermatol. Venereol. 2007, 21, 1–10.
16. Nair, J.R.; Moots, R.J. Behcet’s disease. Clin. Med. 2017, 17, 71–77.
17. Nguyen, A.; Upadhyay, S.; Javaid, M.A.; Qureshi, A.M.; Haseeb, S.; Javed, N.; Cormier, C.; Farooq, A.; Sheikh, A.B. Behcet’s Disease: An In-Depth Review about Pathogenesis, Gastrointestinal Manifestations, and Management. Inflamm. Intestig. Dis. 2021, 6, 175–185.
18. Yazici, H.; Ugurlu, S.; Seyahi, E. Behçet syndrome: Is it one condition? Clin. Rev. Allergy Immunol. 2012, 43, 275–280.
19. Bettiol, A.; Prisco, D.; Emmi, G. Behçet: The syndrome. Rheumatology 2020, 1, 59.
20. Krause, I.; Yankevich, A.; Fraser, A.; Rosner, I.; Mader, R.; Zisman, D.; Boulman, N.; Rozenbaum, M.; Weinberger, A. Prevalence and clinical aspects of Behcet’s disease in the north of Israel. Clin. Rheumatol. 2007, 26, 555–560.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr Wasif Mushtaq
Medical officer, Social Security Hospital, Faisalabad, Pakistan
Dr Fariha Tariq
Assistant Professor Department of Forensic Medicine King Edward Medical University Lahore, Pakistan
Dr Anam Mahmood
Senior Demonstrator Department of Pathology University college of Medicine and Dentistry, University of Lahore, Pakistan
Dr. Sarwat Jahan
Associate Professor Department of Pharmacology and Therapeutics, Aziz Fatimah Medical and Dental College, Faisalabad, Pakistan
Dr Fareeha Naseer Syed
Assistant Professor of Pathology, CMH Multan Institute of Medical Sciences, Multan, Pakistan
Dr Zafar Iqbal Ghafoor
Assistant Professor Pharmacology Department Quaid e Azam Medical College, Bahawalpur, Pakistan