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Published on: May 13, 2019
Iron deficiency is a possible risk factor causing right heart failure in Tibetan children living in high altitude
Jiayun Yu1, Li Yu2,3, Yifei Li2,3
1State Key Laboratory of Biotherapy and Cancer Center, West China Hospital.
Insights
Iron deficiency is a significant risk factor for right heart failure (RHF) in Tibetan children living at high altitudes. Early prevention and treatment of iron deficiency may help reduce RHF incidence in this population.
Area of Science:
- Pediatric Cardiology
- Environmental Health
- Hematology
Background:
- Right heart failure (RHF) poses a significant health challenge, particularly in high-altitude populations.
- Tibetan children residing at high altitudes may face unique risk factors for cardiovascular conditions.
- Iron deficiency is a common comorbidity that warrants investigation for its role in RHF.
Purpose of the Study:
- To investigate the association between iron deficiency and the risk of right heart failure (RHF) in Tibetan children.
- To identify clinical risk factors for RHF in high-altitude dwelling Tibetan children.
- To explore the potential of iron deficiency as a modifiable risk factor for RHF.
Main Methods:
- Retrospective study analyzing data from Tibetan children (2011-2018).
- Included demographic, clinical, laboratory (ferritin, hemoglobin, C-reaction protein), and echocardiographic data.
- Statistical analysis, including binary logistic regression and ROC curve analysis, to identify independent risk factors.
Main Results:
- Higher pulmonary arterial systolic pressure and lower ferritin levels were identified as independent risk factors for RHF.
- Lower ferritin levels (cutoff 14.6 μg/L) showed high sensitivity (81.4%) and specificity (89.2%) for RHF prediction.
- Age and altitude of residence were also significant factors differentiating RHF and non-RHF groups.
Conclusions:
- Iron deficiency is a potential risk factor for RHF in Tibetan children living at high altitudes.
- Management of iron deficiency may be a crucial strategy for preventing RHF in this vulnerable population.
- Further research is needed to confirm the causal link and optimize treatment strategies.
Abstract:
The aim of the study is to discuss the risk factor of right heart failure (RHF) especially the association of iron deficiency with RHF in Tibetan children who live in high altitude area. In this retrospective study, we collected the data of Tibetan children from January 2011 to December 2018 in our hospital. The patients included in the study had the following data: age, gender, ferritin, echocardiography, hemoglobin, C-reaction protein, and altitude of residence. According to whether RHF was diagnosed, the patients were divided into RHF group and non-RHF group. Totally 133 patients were included with 59 in RHF group and 74 in non-RHF group. In single factor analysis, age (P = .008), altitude of residence (P < .001), ferritin (P < .001), and pulmonary arterial systolic pressure (P < .001) showed significant difference between the 2 groups. Binary logistic regression was performed to further identify the association of the clinical factors with RHF. Higher pulmonary arterial systolic pressure (odds ratio: 29.303, 95% confidence interval: 5.249-163.589, P < .001) and lower ferritin level (odds ratio: 5.849, 95% confidence interval: 1.585-21.593, P = .008) were independent risk factors associated with RHF. In receiver-operating characteristic curve, the optimal cutoff value of ferritin level was 14.6 μg/L with the sensitivity of 81.4% and specificity of 89.2%. As continuous variable, the correlation between ferritin and RHF was not certain (P = .281). Due to the possibility that iron deficiency be a risk factor of RHF in Tibetan children, prevention and treatment of iron deficiency might be a potential way in reducing the incidence of RHF in this high altitude area.
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