Savarese A, Probo M, Locatelli C, Gazzonis A L, Zanzani S A, Traini G, Vitiello T, Brambilla P G
Department of Veterinary Medicine (DIMEVET), University of Milan, via Celoria 10, 20133 Milan, Italy.
Pol J Vet Sci. 2018 Sep;21(3):507-515. doi: 10.24425/122625.
In humans, iron deficiency represents a relevant occurrence in heart failure (HF), with or without anaemia, and is associated with the worst outcome. Moreover, chronic kidney disease (CKD) is a well-known comorbidity of HF and is strongly associated with the risk of developing anaemia. The most common cause of HF in dogs is myxomatous mitral valve disease (MMVD). To the best of our knowledge, no studies have examined the iron status in dogs with HF, with and without CKD. The aim of this retrospective study was to evaluate the iron status in dogs affected by MMVD and how strong is the relation with HF. The retrospective study included 54 dogs with complete case records, echocardiography and laboratory analyses. Iron status was evaluated by measuring serum iron concentration (SIC), un- saturated iron binding capacity (UIBC), total iron binding capacity (TIBC), and percentage of saturation (%SAT). The prevalence of dogs showing low serum iron concentration (SIC) was 18% in the whole population, 33% in symptomatic patients, 100% in dogs with acute decompensated HF. No signif- icant differences in SIC, UIBC, TIBC and %SAT median values were found among dogs classi- fied in different ACVIM (American College of Veterinary Internal Medicine) classes, between symptomatic and non-symptomatic patients, and among IRIS (International Renal Interest Soci- ety) classes. Azotemic and non-azotemic patients presented a significant difference in SIC mean values (p=0.02). Generalised linear model (GLM) revealed that dogs with low SIC were at high- er risk of being included in a higher ACVIM class (OR=6.383, p-value=0.014). Log-rank analysis showed shorter survival in dogs with low SIC (p=0.020), multivariate Cox analysis revealed that only HF symptoms can affect survival.
在人类中,缺铁在心力衰竭(HF)中较为常见,无论是否伴有贫血,且与最差的预后相关。此外,慢性肾脏病(CKD)是HF的一种常见合并症,与发生贫血的风险密切相关。犬类HF最常见的病因是黏液瘤性二尖瓣疾病(MMVD)。据我们所知,尚无研究探讨患有或未患有CKD的HF犬的铁状态。这项回顾性研究的目的是评估受MMVD影响的犬的铁状态,以及其与HF的关联强度。该回顾性研究纳入了54只具有完整病例记录、超声心动图和实验室分析的犬。通过测量血清铁浓度(SIC)、未饱和铁结合能力(UIBC)、总铁结合能力(TIBC)和饱和度百分比(%SAT)来评估铁状态。在整个群体中,血清铁浓度(SIC)低的犬的患病率为18%,有症状的患者中为33%,急性失代偿性HF的犬中为100%。在不同ACVIM(美国兽医内科学会)分级的犬、有症状和无症状的患者以及IRIS(国际肾脏兴趣协会)分级之间,SIC、UIBC、TIBC和%SAT的中位数未发现显著差异。氮质血症和非氮质血症患者的SIC平均值存在显著差异(p=0.02)。广义线性模型(GLM)显示,SIC低的犬被纳入更高ACVIM分级的风险更高(OR=6.383,p值=0.014)。对数秩分析显示,SIC低的犬生存时间较短(p=0.020),多变量Cox分析显示只有HF症状会影响生存。