Related Experiment Video
Updated: Nov 9, 2025
Author Spotlight: Developing a Point-of-Care Hemoglobin Estimation Method for Anemia Management
Published on: January 19, 2024
Does Iron Deficiency Affect the Heart in Children?
Fadime Demir1, Seyma Kayali1, Dilek G Gokcebay2
1Pediatric Cardiology.
Insights
Iron deficiency in children without structural heart disease is linked to prolonged cardiac repolarization parameters, suggesting an increased arrhythmia risk. Monitoring iron stores and ECGs is crucial for these children.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Health
- Electrophysiology
Background:
- Serum iron parameters are crucial for cardiovascular health.
- Iron deficiency can cause cardiac issues like conduction abnormalities and dysfunction.
- Limited research exists on iron deficiency's cardiac effects in children.
Purpose of the Study:
- To investigate the impact of low iron stores on cardiac repolarization in children.
- To assess the relationship between ferritin levels and parameters predicting arrhythmia and cardiac function.
Main Methods:
- Prospective evaluation of 135 children (2-18 years) without structural heart disease.
- Stratification into three groups based on ferritin levels (<15, 15-25, >25 ng/mL).
- Utilized 12-lead surface electrocardiography (ECG) and transthoracic echocardiogram for assessments.
Main Results:
- Children with low ferritin (<15 ng/mL) showed significantly prolonged repolarization parameters (Pw, QT, Tp-Te intervals and their variants) compared to the high ferritin group (>25 ng/mL).
- A negative correlation was observed between ferritin levels and prolonged repolarization parameters.
- No significant differences were found in systolic function or ventricular dimensions.
Conclusions:
- Low iron stores in children may predispose them to arrhythmias.
- Careful ECG evaluation and monitoring of children with low iron are essential.
- Further research into iron's role in pediatric cardiac electrophysiology is warranted.
Introduction:
It is well known that serum iron parameters are closely related to cardiovascular health. Iron deficiency may lead to significant cardiac problems, such as atrioventricular conduction abnormalities, and systolic and/or diastolic dysfunction. Studies related to the effect of iron deficiency on cardiac functions are limited in children. Therefore, the aim of this study was to evaluate the effect of low iron stores on cardiac repolarization parameters which are used to predict arrhythmia and cardiac functions.
Materials And Methods:
Onehundred thirty-five children 2 to 18 years of age without structural heart disease who were referred to the Pediatric Cardiology Department for various reasons such as chest pain, heart murmur, or evaluation before sports participation were evaluated prospectively. The cases were separated into 3 groups according to ferritin levels (group 1: ferritin <15 ng/mL [n=48], group 2: ferritin 15 to 25 ng/mL [n=51], and group 3: ferritin >25 ng/mL [n=36]). Evaluations were made with detailed 12-lead surface electrocardiography (ECG) and transthoracic echocardiogram. Cardiac repolarization parameters were measured from surface ECG and systolic functions, left ventricular wall diameters were evaluated from transthoracic echocardiogram.
Results:
Eighty-four (62.2%) girls and 51 (37.8%) boys are included in the study. The average age of the groups was similar. In children with low ferritin levels (group 1); Pw, Pw max, and Pw dis; QT, QTc, and QTc dis; Tp-Te, Tp-Te dis, Tp-Te/QT, and Tp-Te/QTc were significantly longer compared with the group 3 (P<0.05). There was a negative correlation between ferritin level and Pw, P max, and Pw dis; QT, QT dis, QTc, and QTc dis; Tp-Te, Tp-Te dis, Tp-Te/QT, and Tp-Te/QTc (P<0.05). No correlation was found between ferritin level and Pw min. There was no difference between the groups in respect of ejection phase indices, heart wall measurements, and end-diastolic diameter measurements.
Conclusion:
Iron deficiency may be related to the tendency of arrhythmias in children without structural heart disease. Therefore, careful evaluation of ECG parameters of healthy children with low iron stores, and follow up with intermittent monitoring is highly important.
Related Concept Videos
01:24Factors Affecting Erythropoiesis
Several factors influence the erythrocyte production rate, with tissue oxygen level being among the most critical. Intense exercise or high altitudes can cause tissue hypoxia, which triggers the kidneys to release more erythropoietin (EPO) into the bloodstream.
EPO then...
01:27Heart Failure I: Introduction
01:27Anatomy of the Heart
01:27Disorders of Erythrocytes
Erythrocyte disorders can be broadly categorized into two main types: anemic and polycythemic conditions.
A low oxygen-carrying capacity of the blood due to the loss, lower production, or destruction of erythrocytes is termed anemia. Hemorrhagic anemia, for example, occurs when bleeding from an external wound or internal ulcer reduces erythrocyte counts.
On the other...
01:17Ischemic Heart Disease: Overview
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
01:19Cardiac Output I:Effect of Heart Rate on Cardiac Output
Cardiac output (CO) refers to the total amount of blood ejected by one of the ventricles in liters per minute (L/min). In a resting adult, CO ranges from 5 to 6 L/min, adjusting according to the body's metabolic requirements.
Effect of Heart Rate on Cardiac Output
Cardiac output adapts to metabolic demands during stress, physical activity, or illness. The autonomic nervous system regulates heart rate via the sinoatrial node. The parasympathetic nervous system decreases heart...