Correlation Between Hemoglobin Levels and Functional Status in Heart Failure Patients

Background: Anemia is a frequent comorbidity in chronic heart failure (HF) and is associated with increased morbidity, rehospitalizations, and mortality. Low hemoglobin levels impair oxygen delivery, exacerbate myocardial dysfunction, and worsen exercise tolerance, leading to poor functional status. Objectives: 1. To determine the prevalence of anemia among patients with chronic HF. 2. To evaluate the correlation between hemoglobin levels and functional status using the New York Heart Association (NYHA) classification. 3. To assess the impact of anemia on hospitalizations and disease severity. Methods: A cross-sectional study was conducted in the Department of Medicine between July 2023 and June 2024. A total of 120 consecutive patients with clinically and echocardiographically confirmed chronic HF were enrolled. Hemoglobin levels were measured and anemia defined as <13 g/dL in men and <12 g/dL in women (WHO criteria). Functional status was classified according to NYHA grades I–IV. Correlation analysis between hemoglobin and NYHA class was performed using Pearson’s coefficient. Results: Anemia was present in 48.3% (58/120) of HF patients. The mean hemoglobin level was significantly lower in anemic patients (11.2 ± 1.9 g/dL) than in non-anemic patients (13.9 ± 1.4 g/dL, p < 0.01). Advanced functional limitation (NYHA III–IV) was more frequent in the anemic group (69% vs. 32% in non-anemic). Hemoglobin levels showed a moderate negative correlation with NYHA class (r = –0.42, p < 0.01). Hospitalizations in the past year were significantly higher in anemic patients (42% vs. 18%). Conclusion: Anemia is common in heart failure patients and strongly correlates with worse functional status and higher hospitalization rates. Regular screening and management of anemia should be integrated into HF care to improve outcomes.