Center for Congential Heart Diseases, Department of Paediatric Cardiology, Beatrix Children's Hospital, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
Department of Cardiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
Open Heart. 2024 Jun 5;11(1):e002693. doi: 10.1136/openhrt-2024-002693.
Iron deficiency (ID) has been reported in patients with congenital heart disease. There is, however, a scarcity of data on its prevalence in patients with a Fontan circulation. The aim of this study is to investigate the prevalence of ID in Fontan patients and to investigate the association between ID and exercise capacity in this population.
Blood count and haematological parameters were determined in plasma of 61 Fontan patients (51% female, mean age 29±9 years). ID was defined as transferrin saturation (TSAT) ≤19.8%. The prevalence of ID was 36% (22/61 patients). Especially among women, the diagnosis of ID was highly prevalent (52%) despite normal haemoglobin levels (153.7±18.4 g/L). Mean ferritin levels were 98±80 µg/L and mean TSAT levels were 22%±12%. Cardiopulmonary exercise testing was performed in 46 patients (75%). Patients with ID had a lower peak oxygen uptake (V̇Opeak) (1397±477 vs 1692±530 mL/min; p=0.039), although this relationship was confounded by sex. The presence of ID increased the likelihood of not achieving a respiratory exchange ratio (RER) ≥1.1 by 5-fold (p=0.035).
ID is highly prevalent among patients with a Fontan circulation. V̇Opeak is lower in patients with ID. Fontan patients with ID are less likely to achieve an RER≥1.1 during cardiopulmonary exercise testing.
已有研究报道先天性心脏病患者存在铁缺乏症（ID）。然而，Fontan 循环患者中 ID 的患病率数据却很少。本研究旨在调查 Fontan 患者中 ID 的患病率，并研究该人群中 ID 与运动能力之间的关系。
对 61 例 Fontan 患者（51%为女性，平均年龄 29±9 岁）的血浆进行了血常规和血液学参数检测。ID 的定义为转铁蛋白饱和度（TSAT）≤19.8%。ID 的患病率为 36%（22/61 例患者）。尽管血红蛋白水平正常（153.7±18.4 g/L），但女性 ID 的诊断率却很高（52%）。平均铁蛋白水平为 98±80 µg/L，平均 TSAT 水平为 22%±12%。对 46 例患者（75%）进行了心肺运动测试。ID 患者的峰值摄氧量（V̇Opeak）较低（1397±477 比 1692±530 mL/min；p=0.039），尽管这种关系受到了性别的影响。存在 ID 使未达到呼吸交换率（RER）≥1.1 的可能性增加了 5 倍（p=0.035）。
Fontan 循环患者中 ID 的患病率很高。ID 患者的 V̇Opeak 较低。心肺运动测试中，ID 的 Fontan 患者达到 RER≥1.1 的可能性较低。
