缺铁性心力衰竭的女性和男性表型。对“俄罗斯联邦慢性心力衰竭患者缺铁患病率（J-CHF-RF）”研究的补充分析。

Female and Male Phenotypes of Iron Deficiency in CHF. Additional analysis of the «The Prevalence of Iron Deficiency in Patients With Chronic Heart Failure in the Russian Federation (J-CHF-RF)» study.

机构信息

Lomonosov Medical Research and Educational Center.

National Medical Research Center for Therapy and Preventive Medicine.

出版信息

Kardiologiia. 2023 Sep 30;63(9):3-13. doi: 10.18087/cardio.2023.9.n2413.

DOI:10.18087/cardio.2023.9.n2413

PMID:37815134

Abstract

Aim To evaluate the incidence of iron deficiency (ID) in men and women with chronic heart failure (CHF) and to compare clinical and functional indexes in patient with and without ID depending on the gender.Material and methods An additional analysis of the study "Prevalence of Iron Deficiency in Patients With Chronic Heart Failure in the Russian Federation (ID-CHF-RF)" was performed. The study included 498 (198 women, 300 men) patients with CHF, in whom, in addition to iron metabolism, the quality of life and exercise tolerance (ET) were studied. 97 % of patients were enrolled during their stay in a hospital. ID was defined in consistency with the European Society of Cardiology (ESC) Guidelines. Also, and additional analysis was performed according to ID criteria validated by the morphological picture of the bone marrow.Results ID was detected in 174 (87.9 %) women and 239 (79.8 %) men (p=0.028) according to the ESC criteria, and in 154 (77.8 %) women and 217 (72.3 %) men (p=0.208) according to the criteria validated by the morphological picture of the bone marrow. Men with ID were older and had more severe CHF. They more frequently had HF functional class (FC) III and IV (63.4 % vs. 43.3 % in men without ID); higher concentrations of N-terminal pro-brain natriuretic peptide (NT-proBNP) and lower ET. HF FC III increased the probability of ID presence 3.4 times (p=0.02) and the probability of HF FC IV 13.7 times (p=0.003). This clinical picture was characteristic of men when either method of determining ID was used. In women, ID was not associated with more severe CHF.Conclusion Based on the presented analysis, it is possible to characterize the male and female ID phenotypes. The male ID phenotype is associated with more severe CHF, low ET, and poor quality of life. In females of the study cohort, ID was not associated with either the severity of CHF or with ET.

摘要

目的评估慢性心力衰竭（CHF）男性和女性患者缺铁（ID）的发生率，并根据性别比较 ID 患者和非 ID 患者的临床和功能指标。

材料与方法对“俄罗斯慢性心力衰竭患者铁缺乏症患病率（ID-CHF-RF）”研究进行了附加分析。该研究纳入 498 例（198 例女性，300 例男性）CHF 患者，除了铁代谢外，还研究了生活质量和运动耐量（ET）。97%的患者在住院期间入组。根据欧洲心脏病学会（ESC）指南定义 ID。还根据骨髓形态学验证的 ID 标准进行了附加分析。

结果根据 ESC 标准，174 例（87.9%）女性和 239 例（79.8%）男性（p=0.028）、根据骨髓形态学验证的 ID 标准，154 例（77.8%）女性和 217 例（72.3%）男性（p=0.208）检测到 ID。有 ID 的男性年龄更大，CHF 更严重。他们更常出现心力衰竭功能分级（FC）III 和 IV（有 ID 的男性为 63.4%，无 ID 的男性为 43.3%）；N 端脑利钠肽前体（NT-proBNP）浓度更高，ET 更低。HF FC III 使 ID 存在的可能性增加 3.4 倍（p=0.02），HF FC IV 使 ID 存在的可能性增加 13.7 倍（p=0.003）。当使用任何一种 ID 检测方法时，这种临床特征都与男性有关。在女性中，ID 与更严重的 CHF 无关。

结论根据本研究分析，可描述男性和女性 ID 表型。男性 ID 表型与更严重的 CHF、低 ET 和生活质量差有关。在研究队列的女性中，ID 与 CHF 的严重程度或 ET 均无关。