Related Experiment Videos
Cardiovascular function before and after iron therapy by echocardiography in patients with iron deficiency anemia
R Hayashi1, S Ogawa, Z Watanabe
1Department of Pediatrics, Nippon Medical School, Tokyo, Japan.
Insights
Children with iron deficiency anemia show impaired left ventricular contractility. Iron therapy improved systolic function, suggesting anemia affects cardiac performance.
Area of Science:
- Pediatric Cardiology
- Hematology
- Cardiovascular Physiology
Background:
- Iron deficiency anemia (IDA) can impact cardiovascular function.
- Left ventricular (LV) contractility assessment in pediatric IDA is not well-established.
Purpose of the Study:
- To estimate LV contractility in pediatric IDA using the LV end-systolic wall stress to LV end-systolic volume index ratio.
- To evaluate the effects of iron therapy on cardiovascular function in children with IDA.
Main Methods:
- Echocardiography and pulsed Doppler echocardiography were used in 30 children (3-14 years) with IDA (hemoglobin 4.9-8.5 g/dL) before, during, and after iron therapy.
- A control group of 38 healthy children was included for comparison.
Main Results:
- Before iron therapy, patients with IDA had higher LV preload, lower afterload, and a significantly lower LV end-systolic wall stress to LV volume index (2.13 +/- 0.44) compared to controls (3.42 +/- 0.70).
- Early diastolic filling and cardiac index were significantly higher in anemic patients before therapy.
- After iron therapy, cardiovascular indices in anemic patients normalized, showing no significant difference compared to controls.
Conclusions:
- A reduced LV end-systolic wall stress to LV volume index indicates impaired LV contractility in pediatric IDA.
- Hemoglobin levels <= 6 g/dL are associated with LV dysfunction and circulatory congestion.
- Iron therapy effectively reverses the cardiac dysfunction associated with IDA in children.
Background:
The aim of the study was to estimate the left ventricular contractility using the ratio of left ventricular end-systolic wall stress to left ventricular end-systolic volume index in patients with iron deficiency anemia, for which there are no previous reports.
Methods:
Cardiovascular functions were evaluated using echocardiography and pulsed Doppler echocardiography in 30 children aged 3-14 years (hemoglobin 4.9-8.5 g/dL), before, during and after iron therapy. We also studied 38 healthy children as a control group.
Results:
The left ventricular preload was significantly higher and the left ventricular afterload was lower in the patients with anemia before iron therapy. The ratio of left ventricular end-systolic wall stress to left ventricular volume, an index of systolic function that is independent of preload and afterload, was significantly lower in the patients with anemia before iron therapy (before iron therapy 2.13 +/- 0.44, after therapy 3.52 +/- 0.76, healthy controls 3.42 +/- 0.70). Left ventricular early diastolic filling was significantly higher in the patients with anemia before iron therapy. The cardiac index was also significantly higher before therapy because of the increases in preload, heart rate and early diastolic filling, as well as the decrease of afterload. There were no significant differences in the indices of cardiovascular function between anemic patients after iron therapy compared with control subjects.
Conclusions:
The ratio of left ventricular end-systolic wall stress to the left ventricular volume index and the cardiac index suggested that a hemoglobin concentration < or = 6 g/dL was associated with left ventricular dysfunction and circulatory congestion.