Background: Hepcidin plays a vital role in controlling iron homeostasis. Functional iron deficiency as well as anemia are common in heart failure, and it is hypothesized that hepcidin plays a significant role in both conditions. This study aimed to assess the relationship between hepcidin and anemia with the correlation of cardiac functions among congestive heart failure (CHF) pediatric cases.

Methods: Our case-control study was performed in the Pediatrics department at Zagazig University Hospital on 42 participants divided into Group I: 21 Cases of congestive heart failure. Group II: 21 healthy Controls, serum hepcidin level was assessed among all participants.

Results: A statistically significant decrease was found in hepcidin level among studied CHF cases (p<0.001). High statistically significant positive correlations were found between hepcidin level and hemoglobin, red blood cells (RBCs) count, and ejection fraction (EF) of the studied cases (p<0.001, 0.008, <0.001 respectively). There was a high statistically significant decrease in hepcidin level assessed among severe CHF cases (ROSS grade 4) than cases of grade II and III (p<0.001). The sensitivity of hepcidin level in the prediction of CHF was 95.2% at a level less than 30.8 with the ability to exclude 90.5% of healthy cases and 92.9% test accuracy. Sensitivity of hepcidin level in prediction of severe CHF was 85.7% at a level less than 27.6 with ability to exclude 76.6% of mild cases, 83.3% test accuracy.

Conclusions: children with congestive heart failure, serum hepcidin level is a promising biomarker for anemia, it can predict severity of heart failure.