Sutil-Vega Mario, Rizzo Marcelo, Martínez-Rubio Antoni
Cardiac Imaging Unit, Department of Cardiology, Parc Taulí University Hospital (Universitat Autònoma de Barcelona), Barcelona, Spain.
Heart Failure Unit, Department of Cardiology, Parc Taulí University Hospital (Universitat Autònoma de Barcelona), Barcelona, Spain.
Echocardiography. 2019 Mar;36(3):585-594. doi: 10.1111/echo.14271. Epub 2019 Jan 28.
Anemia and iron deficiency are often associated with heart failure, influencing the symptoms and prognosis. Correction of anemia and iron deficiency improves functional capacity and decreases hospitalizations. Many studies have analyzed echocardiographic parameters in iron deficiency and anemia and their evolution after iron treatment; however, the heterogeneity of the results makes it difficult to draw conclusions. The aim of this paper is to review the echocardiographic parameters during anemia and iron deficiency, and their evolution after treatment. Available data suggest that they lead to ventricular and atrial remodeling, a decrease in ventricular contractility, and an alteration of ventricular relaxation, although in heart failure with preserved ejection fraction these changes are not significant. Anemia and iron deficiency also increase systolic pulmonary artery pressure. There is consistent evidence that correction of these comorbidities leads to a reduction in preload and left ventricular cavity dimensions, an improvement in diastolic and load-independent ventricular systolic function parameters, and a decrease in systolic pulmonary artery pressure. However, the evidence is less consistent about the changes produced in ventricular hypertrophy, load-dependent systolic function parameters, and E-wave. Generally, anemia and iron deficiency affect the echocardiographic findings, and correcting these conditions often results in improvement in the affected echocardiographic parameters.
贫血和缺铁常与心力衰竭相关，影响症状和预后。纠正贫血和缺铁可改善功能能力并减少住院次数。许多研究分析了缺铁和贫血时的超声心动图参数及其铁治疗后的变化；然而，结果的异质性使得难以得出结论。本文旨在综述贫血和缺铁期间的超声心动图参数及其治疗后的变化。现有数据表明，它们会导致心室和心房重塑、心室收缩力下降以及心室舒张改变，尽管在射血分数保留的心力衰竭中这些变化并不显著。贫血和缺铁还会增加收缩期肺动脉压。有一致的证据表明，纠正这些合并症可导致前负荷和左心室腔尺寸减小、舒张和与负荷无关的心室收缩功能参数改善以及收缩期肺动脉压降低。然而，关于心室肥厚、与负荷相关的收缩功能参数和E波产生的变化，证据不太一致。一般来说，贫血和缺铁会影响超声心动图表现，纠正这些情况通常会导致受影响的超声心动图参数得到改善。
