1st Department of Internal Medicine-Cardioangiology, St. Anne's University Hospital, 60200 Brno, Czech Republic.
Faculty of Medicine, Masaryk University, 60200 Brno, Czech Republic.
Medicina (Kaunas). 2022 Oct 31;58(11):1569. doi: 10.3390/medicina58111569.
Background and Objectives: Iron deficiency (ID) is a common comorbidity in patients with heart failure. It is associated with reduced physical performance, frequent hospitalisations for heart failure decompensation, and high cardiovascular and overall mortality. The aim was to determine the prevalence of ID in patients with advanced heart failure on the waiting list for heart transplantation. Methods and Materials: We included 52 patients placed on the waiting list for heart transplantation in 2021 at our centre. The cohort included seven patients with LVAD (left ventricle assist device) as a bridge to transplantation implanted before the time of results collection. In addition to standard tests, the parameters of iron metabolism were monitored. ID was defined as a ferritin value <100 µg/L, or 100−299 µg/L if transferrin saturation (T-sat) is <20%. Results: ID was present in 79% of all subjects, but only in 35% of these patients anaemia was expressed. In the group without LVAD, ID was present in 82%, a median (lower−upper quartile) of ferritin level was 95.4 (62.2−152.1) µg/mL and mean T-sat was 0.18 ± 0.09. In LVAD group, ID was present in 57%, ferritin level was 268 (106−368) µg/mL and mean T-sat was 0.14 ± 0.04. Haemoglobin concentration was the same in patients with or without ID (133 ± 16) vs. (133 ± 23). ID was not associated with anaemia defined with regard to patient’s gender. In 40.5% of cases, iron deficiency was accompanied by chronic renal insufficiency, compared to 12.5% of the patients without ID. In the patients with LVAD, ID was present in four out of seven patients, but the group was too small for reliable statistical testing due to low statistical power. Conclusions: ID was present in the majority of patients with advanced heart failure and was not always accompanied by anaemia and renal insufficiency. Research on optimal markers for the diagnosis of iron deficiency, especially for specific groups of patients with heart failure, is still ongoing.
铁缺乏症（ID）是心力衰竭患者的常见合并症。它与体力活动下降、心力衰竭失代偿频繁住院以及心血管和总体死亡率升高有关。本研究旨在确定等待心脏移植的晚期心力衰竭患者中 ID 的患病率。
我们纳入了 2021 年在我们中心等待心脏移植的 52 名患者。该队列包括 7 名在结果采集前植入左心室辅助装置（LVAD）作为移植桥的患者。除了标准检查外，还监测了铁代谢参数。ID 定义为铁蛋白值 <100 µg/L，或转铁蛋白饱和度（T-sat）<20%时为 100-299 µg/L。
所有患者中 ID 的患病率为 79%，但只有 35%的患者出现贫血。在无 LVAD 组中，ID 的患病率为 82%，中位数（下四分位数-上四分位数）铁蛋白水平为 95.4（62.2-152.1）µg/mL，平均 T-sat 为 0.18 ± 0.09。在 LVAD 组中，ID 的患病率为 57%，铁蛋白水平为 268（106-368）µg/mL，平均 T-sat 为 0.14 ± 0.04。有或无 ID 的患者的血红蛋白浓度相同（133 ± 16）vs.（133 ± 23）。ID 与按患者性别定义的贫血无关。在 40.5%的情况下，缺铁症伴有慢性肾功能不全，而无 ID 的患者中这一比例为 12.5%。在有 LVAD 的患者中，7 名患者中有 4 名存在 ID，但由于统计效能较低，该组的样本量太小，无法进行可靠的统计检验。
大多数晚期心力衰竭患者存在 ID，且并不总是伴有贫血和肾功能不全。针对心力衰竭特定患者群体的铁缺乏症的最佳诊断标志物的研究仍在进行中。
