Doehner Wolfram, Blankenberg Stefan, Erdmann Erland, Ertl Georg, Hasenfuß Gerd, Landmesser Ulf, Pieske Burkert, Schieffer Bernhard, Schunkert Heribert, von Haehling Stephan, Zeiher Andreas, Anker Stefan D
Interdisziplinäre Schlaganfallforschung, Centrum für Schlaganfallforschung Charité Berlin.
Klinik für Allgemeine und Interventionelle Kardiologie, Universitäres Herzzentrum Hamburg.
Dtsch Med Wochenschr. 2017 May;142(10):752-757. doi: 10.1055/s-0043-100900. Epub 2017 Mar 16.
Iron deficiency (ID) occurs in up to 50% of patients with heart failure (HF). Even without presence of anaemia ID contributes to more severe symptoms, increased hospitalization and mortality. A number of randomized controlled trials demonstrated the clinical benefit of replenishment of iron stores with improvement of symptoms and fewer hospitalizations. Assessment of iron status should therefore become routine assessment in newly diagnosed and in symptomatic patients with HF. ID can be identified with simple and straightforward diagnostic steps. Assessment of Ferritin (indicating iron stores) and transferrin saturation (TSAT, indication capability to mobilise internal iron stores) are sufficient to detect ID. In this review a plain diagnostic algorithm for ID is suggested. Confounding factors for diagnosis and adequate treatment of ID in HF are discussed. A regular workup for iron deficiency parameters may benefit patients with heart failure by providing symptomatic improvements and fewer hospitalizations.
缺铁（ID）在高达50%的心力衰竭（HF）患者中出现。即使不存在贫血，缺铁也会导致更严重的症状、住院率增加和死亡率上升。多项随机对照试验证明补充铁储备对改善症状和减少住院有临床益处。因此，对铁状态的评估应成为新诊断的和有症状的HF患者的常规评估。通过简单直接的诊断步骤即可识别缺铁。评估铁蛋白（表明铁储备）和转铁蛋白饱和度（TSAT，表明动员体内铁储备的能力）足以检测缺铁。在本综述中，提出了一种简单的缺铁诊断算法。讨论了心力衰竭中缺铁诊断和适当治疗的混杂因素。定期检查缺铁参数可能会使心力衰竭患者症状改善、住院减少。
