From the Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.
ASAIO J. 2022 Jul 1;68(7):899-906. doi: 10.1097/MAT.0000000000001585. Epub 2022 Oct 12.
Iron deficiency (ID) is a common comorbidity in heart failure (HF). In these patients, intravenous iron administration can improve clinical outcomes and quality of life (QoL). However, data on ID are lacking in patients who have transitioned toward left ventricular assist device (LVAD) or heart transplantation (HTx). All patients who underwent LVAD (n = 84) surgery or HTx (n = 67) at our center between 2012 and 2019, aged ≥18 years with a follow-up of ≥3 months, were included. Retrospectively, the prevalence of ID up to 1 year preoperatively, and up to February 2020 postoperatively, as well as all iron administrations were assessed during this period. Iron status was assessed in 61% and 51% of the LVAD and HTx patients preoperatively, and 81% and 84%, respectively, postoperatively. Of these patients, 53% and 71% of the LVAD and HTx patients preoperatively were diagnosed with ID preoperatively, and 71% and 77%, respectively, postoperatively. ID was more frequently diagnosed >3 months postoperatively. Sixty-three percent of the LVAD (mostly intravenous) and 63% of the HTx patients (mostly oral) received iron administration. ID is highly prevalent pre- and post-LVAD and HTx. It is plausible that substitution can have similar QoL gains as in regular HF patients.
缺铁（ID）是心力衰竭（HF）的常见合并症。在这些患者中，静脉铁剂治疗可以改善临床结局和生活质量（QoL）。然而，在已经过渡到左心室辅助装置（LVAD）或心脏移植（HTx）的患者中，关于 ID 的数据仍然缺乏。2012 年至 2019 年期间，在我们中心接受 LVAD（n=84）手术或 HTx（n=67）的所有年龄≥18 岁且随访时间≥3 个月的患者均被纳入本研究。回顾性地评估了术前 1 年和术后至 2020 年 2 月的 ID 患病率，以及在此期间的所有铁剂治疗情况。术前有 61%和 51%的 LVAD 和 HTx 患者进行了铁状态评估，术后分别有 81%和 84%进行了评估。在这些患者中，术前有 53%和 71%的 LVAD 和 HTx 患者被诊断为 ID，术后分别有 71%和 77%被诊断为 ID。ID 更常被诊断为术后>3 个月。63%的 LVAD（主要为静脉内）和 63%的 HTx 患者（主要为口服）接受了铁剂治疗。LVAD 和 HTx 术前和术后 ID 均高度流行。替代治疗可能与常规 HF 患者一样带来相似的 QoL 获益，这是合理的。
