Drozd Marcin, Jankowska Ewa A, Banasiak Waldemar, Ponikowski Piotr
Laboratory for Applied Research on Cardiovascular System, Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.
Cardiology Department, Centre for Heart Diseases, Military Hospital, Wroclaw, Poland.
Am J Cardiovasc Drugs. 2017 Jun;17(3):183-201. doi: 10.1007/s40256-016-0211-2.
In patients with heart failure (HF), iron deficiency (ID) correlates with decreased exercise capacity and poor health-related quality of life, and predicts worse outcomes. Both absolute (depleted iron stores) and functional (where iron is unavailable for dedicated tissues) ID can be easily evaluated in patients with HF using standard laboratory tests (assessment of serum ferritin and transferrin saturation). Intravenous iron therapy in iron-deficient patients with HF and reduced ejection fraction has been shown to alleviate HF symptoms and improve exercise capacity and quality of life. In this paper, we provide information on how to diagnose ID in HF. Further we discuss pros and cons of different iron preparations and discuss the results of major trials implementing iron supplementation in HF patients, in order to provide practical guidance for clinicians on how to manage ID in patients with HF.
在心力衰竭(HF)患者中,缺铁(ID)与运动能力下降和健康相关生活质量差相关,并预示着更差的预后。绝对缺铁(铁储存耗竭)和功能性缺铁(特定组织无法获得铁)在HF患者中都可以通过标准实验室检查(评估血清铁蛋白和转铁蛋白饱和度)轻松评估。在射血分数降低的缺铁HF患者中,静脉铁治疗已被证明可缓解HF症状,提高运动能力和生活质量。在本文中,我们提供了关于如何在HF中诊断ID的信息。此外,我们讨论了不同铁制剂的优缺点,并讨论了在HF患者中实施铁补充的主要试验结果,以便为临床医生提供关于如何管理HF患者ID的实用指导。