Mirdamadi Ahmad, Arefeh Asadolahi, Garakyaraghi Mohammad, Pourmoghadas Ali
Islamic Azad university, Najafabad Branch, Isfahan, Iran.
Heart Failure Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan 81465-1148, Iran.
Acta Biomed. 2018 Jun 7;89(2):214-218. doi: 10.23750/abm.v89i2.5020.
Anemia is now considered as an important contributing factor to the deterioration of chronic heart failure. The present study aimed to assess the effects of intravenous iron therapy on clinical condition, left ventricular function and also quality of life in patients who suffered of chronic heart failure and concomitant iron deficiency.
In this clinical trial, 25 consecutive patients with concomitant chronic heart failure and iron deficiency referred to Shariati hospital in Isfahan, Iran in 2013. After initial clinical, laboratory, and echocardiography assessments, the patients administered 200 mg intravenous Iron per week until compensating iron deficit. Then, all study parameters were assessed again and compared to parameters before the therapeutic intervention.
The NYHA class showed a significant improvement after the therapeutic approach. The prevalence of heart failure-related edema was also significantly reduced from 60% before treatment to 48% after that (p = 0.036). The rate of hospitalization was considerably reduced from 42% to 16% (P < 0.001). Moreover, mean 6 minute walk test (6MWT) was increased from 155.18 m to 187.40 m (P < 0.001). Comparing Left Ventricular Ejection Fraction (LVEF) after treatment to figures before the test indicated a significant improvement in this parameter (27.5% versus 33.0%, P = 0.007). The treatment of iron deficiency in this group of subjects got a significant improvement in SF36 total score.
In patients with chronic heart failure, the treatment of iron deficiency results in a marked improvement in functional status, ejection fraction, and also quality of life as well as a reduction in need to re-hospitalization, however renal function was deteriorated and thus more pay attention to renal function is necessary.
贫血目前被认为是慢性心力衰竭恶化的一个重要促成因素。本研究旨在评估静脉铁剂治疗对慢性心力衰竭合并缺铁患者的临床状况、左心室功能以及生活质量的影响。
在这项临床试验中，2013年有25例连续的慢性心力衰竭合并缺铁患者转诊至伊朗伊斯法罕的沙里亚蒂医院。在进行初步的临床、实验室和超声心动图评估后，患者每周静脉注射200毫克铁剂，直至弥补铁缺乏。然后，再次评估所有研究参数，并与治疗干预前的参数进行比较。
治疗后纽约心脏协会（NYHA）心功能分级显示有显著改善。与心力衰竭相关的水肿发生率也从治疗前的60%显著降至治疗后的48%（p = 0.036）。住院率从42%大幅降至16%（P < 0.001）。此外，平均6分钟步行试验（6MWT）从155.18米增加到187.40米（P < 0.001）。将治疗后的左心室射血分数（LVEF）与测试前的数据进行比较，表明该参数有显著改善（27.5%对33.0%，P = 0.007）。对这组受试者缺铁情况的治疗使SF36总分有显著改善。
在慢性心力衰竭患者中，缺铁的治疗可导致功能状态、射血分数以及生活质量显著改善，同时减少再次住院的需求，然而肾功能会恶化，因此有必要更加关注肾功能。
