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Right ventricular function and iron deficiency in acute heart failure.
Gema Miñana1,2, Enrique Santas1, Rafael de la Espriella1
1Cardiology Department, Hospital Clínico Universitario, Universitat de Valencia, INCLIVA, Avda. Blasco Ibáñez 17, 46010 Valencia, Spain.
European Heart Journal. Acute Cardiovascular Care
|February 23, 2021
Summary
Iron deficiency (ID) is common in acute heart failure (AHF). This study found that ID is linked to impaired right ventricular function, specifically lower TAPSE and TAPSE/PASP ratios in AHF patients.
Area of Science:
- Cardiology
- Internal Medicine
- Pulmonology
Background:
- Iron deficiency (ID) is prevalent in patients with chronic and acute heart failure (AHF).
- While ID's impact on left ventricular systolic function is known, its effect on right ventricular function remains unevaluated.
- This study investigates the association between ID and right ventricular dysfunction in AHF.
Purpose of the Study:
- To determine if iron deficiency is associated with greater right ventricular dysfunction in patients admitted with acute heart failure.
- To evaluate the relationship between iron deficiency markers and right ventricular systolic function parameters.
Main Methods:
- Prospective enrollment of 903 patients admitted with AHF.
- Assessment of right systolic function using tricuspid annular plane systolic excursion (TAPSE) and TAPSE/pulmonary artery systolic pressure (TAPSE/PASP) ratio.
- Definition of ID based on European Society of Cardiology criteria (serum ferritin and transferrin saturation - TSAT).
- Multivariate linear regression analyses to evaluate associations between ID and right ventricular function.
Main Results:
- 75% of the 903 AHF patients exhibited iron deficiency.
- Lower serum ferritin and TSAT were independently associated with lower TAPSE.
- TSAT, but not ferritin, was independently associated with the TAPSE/PASP ratio.
Conclusions:
- Proxies of iron deficiency are associated with right ventricular dysfunction in acute heart failure.
- Further research is needed to confirm these findings and elucidate the underlying pathophysiology.
- These results suggest a potential link between iron status and right ventricular performance in AHF.
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