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Evaluation of cardiac function in iron deficiency anemia before and after total dose iron therapy
J F Alvares1, J L Oak, A V Pathare
1Department of Medicine, Seth GS Medical College and KEM Hospital, Parel, Mumbai-400 012.
Insights
Total dose iron therapy improves cardiac function in iron deficiency anemia patients before significant hemoglobin rise. This suggests iron correction at the tissue level benefits heart electrophysiology.
Area of Science:
- Cardiology
- Hematology
- Internal Medicine
Background:
- Iron deficiency anemia (IDA) is linked to impaired cardiac function.
- Understanding the cardiac effects of IDA and its treatment is crucial.
Purpose of the Study:
- To assess cardiac function changes after total dose iron therapy (TDI) in IDA patients.
- To correlate myocardial function improvements with hemoglobin increase post-TDI.
Main Methods:
- 30 IDA patients (11 male, 19 female, mean age 30) were studied.
- Cardiac function assessed via ECG, treadmill stress test (TST), and 2D echocardiogram before and after TDI.
- Hemoglobin levels and clinical features were monitored.
Main Results:
- Mean hemoglobin increased from 5 to 5.7 gm/dl post-TDI.
- Congestive cardiac failure resolved in 4 of 8 patients.
- Heart rate decreased significantly (p=0.011), and effort tolerance improved in 17/24 patients (p=0.0012) even before significant hemoglobin rise.
Conclusions:
- IDA is associated with impaired left ventricular performance.
- TDI improves cardiac function in IDA patients, preceding significant hemoglobin elevation.
- Cardiac improvement may stem from tissue-level iron correction and resolution of electrophysiological abnormalities.
Objective:
To evaluate the cardiac function before and after the total dose iron therapy (TDI) and to correlate the myocardial function to the rise in haemoglobin after TDI in patients of iron deficiency anemia.
Methods:
The study included 30 patients of iron deficiency anemia who presented to our institution in the last one year. There were 11 men and 19 women with the mean age of 30 years. Parameters compared before and after TDI infusion included clinical features, haemoglobin, electrocardiogram (ECG), treadmill stress test (TST) and 2 dimensional echocardiogram (2D echo).
Results:
During the study period 30 patients (11 men and 19 women) were included for TDI. The mean haemoglobin level increased from 5 gm/dl to 5.7 gm/dl 4 days after TDI. The congestive cardiac failure disappeared in four out of eight patients after TDI. The mean heart rate on the ECG pretherapy was 102.66 +/- 14.9 and post therapy 93.4 +/- 14.9 (p = 0.011). The TST results showed improvement in effort tolerance in 17 out of 24 patients (p = 0.0012) and it improved much before there was a significant rise in haemoglobin.
Conclusion:
Impaired ventricular performance is observed in patients with iron deficiency anemia. After TDI the left ventricular function improved before there was a significant rise in haemoglobin level proving the theory that correction of the electrophysiological abnormalities of the heart in iron deficiency patient by TDI may be the result of correction of iron at the tissue level.