Department of Internal Medicine II, Medical University Innsbruck, Innsbruck, Austria.
Christian Doppler Laboratory for Iron Metabolism and Anaemia Research, Medical University Innsbruck, Innsbruck, Austria.
Intern Emerg Med. 2020 Jun;15(4):573-585. doi: 10.1007/s11739-020-02288-1. Epub 2020 Feb 10.
Anaemia is a highly prevalent condition, which negatively impacts on patients' cardiovascular performance and quality of life. Anaemia is mainly caused by disturbances of iron homeostasis. While absolute iron deficiency mostly as a consequence of chronic blood loss or insufficient dietary iron absorption results in the emergence of iron deficiency anaemia, inflammation-driven iron retention in innate immune cells and blockade of iron absorption leads to the development of anaemia of chronic disease. Both, iron deficiency and anaemia have been linked to the clinical course of pulmonary hypertension. Various mechanistic links between iron homeostasis, anaemia, and pulmonary hypertension have been described and current treatment guidelines suggest regular iron status assessment and the implementation of iron supplementation strategies in these patients. The pathophysiology, diagnostic assessment as well as current and future treatment options concerning iron deficiency with or without anaemia in individuals suffering from pulmonary hypertension are discussed within this review.
贫血是一种高发疾病，会对患者的心血管功能和生活质量产生负面影响。贫血主要是由铁稳态紊乱引起的。虽然由于慢性失血或饮食中铁吸收不足导致的绝对缺铁主要导致缺铁性贫血的出现，但先天免疫细胞中炎症驱动的铁保留和铁吸收的阻断会导致慢性病性贫血的发生。缺铁和贫血都与肺动脉高压的临床病程有关。铁稳态、贫血和肺动脉高压之间的各种机制联系已经被描述，并且当前的治疗指南建议在这些患者中定期评估铁状态并实施铁补充策略。本文就肺动脉高压患者伴或不伴贫血的缺铁的病理生理学、诊断评估以及当前和未来的治疗选择进行了讨论。
