Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Heart Center, Alfred Hospital, Melbourne, Australia.
Allergy, Immunology and Respiratory Medicine, Alfred Hospital, Melbourne, Australia.
Heart Lung Circ. 2014 Mar;23(3):287-92. doi: 10.1016/j.hlc.2013.08.007. Epub 2013 Sep 1.
Iron deficiency has been reported to be highly prevalent in idiopathic pulmonary arterial hypertension (iPAH) patients, with the potential to influence cardiac performance, pulmonary artery pressures and the pulmonary vascular response to hypoxia.
Iron status was evaluated in 29 iPAH patients, and was related to haemodynamic, echocardiographic and exercise parameters.
Iron deficiency was present in 44.8% of all iPAH patients, although anaemia was only present in 13.8%. Iron-deficient patients had similar exercise capacity (6MWD: 446±141 m), compared to iron-sufficient patients (421±193 m), however 46.2% of iron deficient patients had NYHA FC 3 or higher, compared to 12.5% in non-iron deficient group. Additionally iron-deficient patients showed increased mean pulmonary arterial pressure (63.3±12.2 mmHg; iron deficient vs. 38.8±16.7 mmHg; non-iron deficient) and reduced cardiac index (1.3±0.2 L/min/m(2); iron deficient vs. 2.5±0.4 L/min/m(2); non-iron deficient).
Iron deficiency is highly prevalent in iPAH, and the extent of iron deficiency is related to haemodynamics and NYHA functional class. While the exact mechanism of iron deficiency is unknown, our study suggests that treatment of iron deficiency should be considered in iPAH patients.
缺铁症在特发性肺动脉高压（iPAH）患者中较为常见，可能会影响心脏功能、肺动脉压力和肺血管对缺氧的反应。
评估了 29 例 iPAH 患者的铁状态，并将其与血流动力学、超声心动图和运动参数相关联。
所有 iPAH 患者中有 44.8%存在缺铁症，尽管只有 13.8%存在贫血。缺铁症患者的运动能力（6MWD：446±141m）与铁充足患者相似（421±193m），然而，46.2%的缺铁症患者的 NYHA FC 为 3 或更高，而非缺铁症组中仅为 12.5%。此外，缺铁症患者的平均肺动脉压（63.3±12.2mmHg；缺铁症患者 vs. 38.8±16.7mmHg；非缺铁症患者）更高，心指数（1.3±0.2L/min/m2；缺铁症患者 vs. 2.5±0.4L/min/m2；非缺铁症患者）更低。
缺铁症在 iPAH 中较为常见，缺铁症的严重程度与血流动力学和 NYHA 功能分级相关。尽管缺铁症的确切机制尚不清楚，但我们的研究表明，应考虑对 iPAH 患者进行缺铁症治疗。
