Relationship Between Hematocrit (HCT) and Heart Failure

Abstract

Heart failure is often accompanied by anemia, which can lead to impaired oxygen supply and serious consequences. Hematocrit (HCT) is an important measure of red blood cell volume and disease severity. This study aimed to determine the prevalence of low hematocrit in heart failure patients and its association with hemodilution, iron deficiency, functional status, and clinical outcomes. Fifty heart failure patients at Mitiga Heart Hospital in Tripoli, Libya, participated in a cross-sectional study. Data collected included demographics, NYHA classification, comorbidities, medications, laboratory markers (hematocrit, hemoglobin, ferritin, transferrin saturation, BNP), and echocardiography (LVEF, LVEDD). The relationship between hematocrit, iron status, hemodilution, and clinical outcomes was studied using descriptive statistics and percentages. Fifty-eight percent of patients had low hemoglobin levels (HCT) (<35%), with the majority being elderly (mean age 61.2 ± 11.4 years) and NYHA class III-IV patients (44%). Thirty-six percent (ferritin <100 ng/mL) and 28% (TSAT <20%) had iron deficiency. Forty percent of patients experienced hemodilation, often accompanied by edema and weight gain. Only 24% of patients received iron supplementation and 12% received erythropoietin despite following guidelines. Anemia was strongly associated with poor outcomes, as evidenced by increased hospitalization rates (32%) and all recorded deaths (6%) among patients with low HCT. Low HCT is very common in heart failure patients and is associated with worse clinical outcomes, iron deficiency, hemodilation, and disease progression. To improve prognosis, targeted therapies, iron status assessment, and routine HCT monitoring are crucial. Further research is needed to confirm this effect. 36% (ferritin <100 ng/mL) and 28% (TSAT <20%) were iron deficient. 40% of patients experienced hemolysis, often accompanied by edema and weight gain. To improve prognosis, targeted therapies, iron status assessment, and periodic monitoring with hematopoietic stem cell imaging (HCT) are crucial. Further research is needed to determine how anemia correction affects survival and functional capacity.