Su Lina, Li Peizhao, Li Zeng, Chen Zhiping, Hu Dan, An Hui, Sun Lijie, Liu Chuanfen, Wu Manyan, Maimaiti Ailifeire, Su Xiaoling, Lu Zhan, Li Sufang, Lamu Gusang, Wang Xi, Gong Jingjing, Lai Jinsheng, Hao Xiang, Zhou Pei, Zhang Hao, Zhang Yanqing, Su Guangsheng, Liu Wenjie, Xu Bihe, Bai Ming, Liu Yujian, Liu Wanjun, Chen Sizhen, Feng Lina, Liu Jiang, Zhou Ying, Zhao Xuecheng, Meng Zhen, Sun Di, Cao Hong-Shuai, Cao Lulei, Kang Naidan, Zheng Zhaoqi, Zhang Hu, Zheng Jingang, Cleland John G F, Ren Jingyi
Heart Failure Center, Department of Cardiology, China-Japan Friendship Hospital, Beijing, China.
Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China.
Heart. 2025 Apr 10;111(9):421-429. doi: 10.1136/heartjnl-2024-324887.
Heart failure (HF) guidelines recommend routine testing for iron deficiency (ID) and, for those with ID, intravenous iron if the left ventricular ejection fraction is <50%. Guideline adherence to these recommendations by cardiologists in China is unknown.
An independent academic web-based survey was designed and distributed via social networks to cardiologists across China. Overall, 1342 cardiologists (median age 34 years, IQR 30-39, 51% women) from all provinces of China completed this survey. More than half were unaware of the need to screen for ID in HF and did not do so routinely in their clinical practice. Approximately 80% were not familiar with the diagnostic criteria for ID in HF guidelines, and only 0.8% recognised transferrin saturation <20% as an independent marker of ID. Regarding iron repletion, only 14% preferred intravenous to oral iron for correcting ID compared with 68% favouring oral iron. Three-quarters were unfamiliar with methods for calculating intravenous iron dose. Furthermore, over 80% were unaware that current guidelines only recommend ferric carboxymaltose or ferric derisomaltose for correcting ID. The main barriers to using intravenous iron were lack of knowledge and experience. Despite such poor awareness and practice, most cardiologists were interested in learning more about managing ID in HF.
In this nationwide survey of cardiologists in China, we identified large gaps in both knowledge and management of ID. This survey will help guide the development of educational programmes to improve care for patients with HF and ID in China.
心力衰竭（HF）指南建议对缺铁（ID）进行常规检测，对于缺铁患者，如果左心室射血分数<50%，则给予静脉铁剂治疗。目前尚不清楚中国心脏病专家对这些建议的遵循情况。
设计了一项基于网络的独立学术调查，并通过社交网络分发给中国各地的心脏病专家。总体而言，来自中国所有省份的1342名心脏病专家（年龄中位数34岁，四分位距30 - 39岁，51%为女性）完成了这项调查。超过一半的人没有意识到在心力衰竭中筛查缺铁的必要性，并且在临床实践中没有常规进行筛查。大约80%的人不熟悉心力衰竭指南中缺铁的诊断标准，只有0.8%的人将转铁蛋白饱和度<20%视为缺铁的独立指标。关于铁剂补充，与68%倾向于口服铁剂相比，只有14%的人更倾向于静脉铁剂来纠正缺铁。四分之三的人不熟悉计算静脉铁剂剂量的方法。此外，超过80%的人不知道当前指南仅推荐使用羧基麦芽糖铁或异麦芽糖酐铁来纠正缺铁。使用静脉铁剂的主要障碍是知识和经验的缺乏。尽管认知和实践情况不佳，但大多数心脏病专家有兴趣更多地了解心力衰竭中缺铁的管理。
在这项对中国心脏病专家的全国性调查中，我们发现缺铁的知识和管理方面都存在很大差距。这项调查将有助于指导制定教育计划，以改善中国心力衰竭和缺铁患者的护理。
