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缺铁的患病率及其对适合经导管主动脉瓣植入术患者6分钟步行试验距离的影响。一项前瞻性研究。

Prevalence of iron deficiency and its influence on six-minute walk test distance in patients eligible for transcatheter aortic valve implantation. A prospective study.

作者信息

Błaszkiewicz Michał, Aleksandrowicz Krzysztof A, Mazur Małgorzata, Witkowski Tomasz G, Kosowski Michał, Kübler Piotr, Reczuch Krzysztof, Protasiewicz Marcin

机构信息

Students' Scientific Group of Invasive Cardiology, Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.

Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland.

出版信息

Postepy Kardiol Interwencyjnej. 2024 Dec;20(4):443-448. doi: 10.5114/aic.2024.144776. Epub 2024 Nov 5.

Abstract

INTRODUCTION

Aortic stenosis (AS) leads to left ventricular outflow tract obstruction and can result in the development of heart failure. Patients with severe AS exhibit similar symptoms to those with iron deficiency (ID), raising the question of whether ID, if diagnosed, could be linked to the lack of physical performance improvement after transcatheter aortic valve implantation (TAVI).

AIM

The aim was to assess the prevalence of ID in patients scheduled for TAVI and to evaluate its impact on 6-minute walk test (6MWT) results.

MATERIAL AND METHODS

Patients with severe AS, qualified for TAVI, were tested for ID, and underwent 6MWT with the assessment of heart rate recovery (HRR) parameters before TAVI and after 3 months.

RESULTS

ID was diagnosed in 59% of screened patients. There was no significant difference in baseline (277.6 ±121.9 m vs. 287.3 ±116.6 m; = 0.74) and follow-up 6MWT distance (313.1 ±119.6 m vs. 319.4 ±111 m; = 0.93) between the two study arms. In both groups the 6MWT distance improved significantly after TAVI (32.1 ±62.9 m in ID group, < 0.003; (39.4 ±68.7 m in non-ID group, < 0.005). There were no statistical differences in HRR parameters between the two groups before and after TAVI.

CONCLUSIONS

The results of the study indicate that ID has no significant effect on 6MWT results before and after the TAVI procedure. ID likely has no impact on physical capacity in patients with severe AS.

摘要

引言

主动脉瓣狭窄(AS)会导致左心室流出道梗阻,并可能引发心力衰竭。重度AS患者表现出与缺铁(ID)患者相似的症状,这就引发了一个问题,即如果诊断出ID,它是否与经导管主动脉瓣植入术(TAVI)后身体机能改善不足有关。

目的

本研究旨在评估计划接受TAVI治疗的患者中ID的患病率,并评估其对6分钟步行试验(6MWT)结果的影响。

材料与方法

对符合TAVI治疗条件的重度AS患者进行ID检测,并在TAVI术前和术后3个月进行6MWT,同时评估心率恢复(HRR)参数。

结果

在筛查的患者中,59%被诊断为ID。两个研究组在基线(277.6±121.9米对287.3±116.6米;P = 0.74)和随访6MWT距离(313.1±119.6米对319.4±111米;P = 0.93)方面均无显著差异。两组在TAVI术后6MWT距离均显著改善(ID组为32.1±62.9米,P<0.003;非ID组为39.4±68.7米,P<0.005)。TAVI术前和术后两组之间的HRR参数无统计学差异。

结论

研究结果表明,ID对TAVI手术前后的6MWT结果没有显著影响。ID可能对重度AS患者的身体机能没有影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c89/11783268/dff425a6e9a3/PWKI-20-55095-g001.jpg

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