铁缺乏症在心力衰竭中的定义 穿过喷射部分的表型:患病率,症状和因果特异性结果
Felix Lindberg1, Carin Corovic Cabrera1, Lina Benson1
1Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, Stockholm, Sweden.
JACC. Heart failure
|October 4, 2025
概括
缺铁 (ID) 在心力衰竭 (HF) 中很常见,并与更差的生活质量有关. 使用转林和度 (TSAT) <20%来定义ID最好识别具有较高死亡和住院风险的患者.
科学领域:
- 心脏病学 心脏病学
- 内部医学 内部医学
- 营养科学 营养科学
背景情况:
- 缺铁 (ID) 定义影响心力衰竭 (HF) 的患病率,预后和治疗益处.
- 了解最佳的ID定义对于患者分层和治疗干预至关重要.
研究的目的:
- 评估四种不同的心力衰竭中ID的定义,其中包括减少,轻度减少和保存的喷射分数 (HFrEF,HFmrEF,HFpEF).
- 评估每个ID定义与健康相关的生活质量 (HR-QoL),症状和临床结果的关联.
主要方法:
- 分析了来自瑞典HF注册表 (2017-2023) 的20673名患者.
- 用四个标准来评估ID:当前的高频指南,IRONMAN试验标准,转激素和 (TSAT) <20%,费里丁<100μg/L.
- 结果包括死亡率,住院,HR-QoL和症状.
主要成果:
- 根据定义,ID患病率各不相同,在HFpEF中最高.
- 所有定义都与症状恶化相关;TSAT<20%和IRONMAN标准与较差的HR-QoL有关.
- 在TSAT<20%和IRONMAN标准中,与不良结果 (包括死亡率和住院病例) 的关联最强.
- TSAT <20%显示出最大的预后准确性和歧视性,特别是在HFpEF.
结论:
- 铁缺乏症在HF类型中非常普遍,并且与不良结果相关,无论定义如何.
- 通过TSAT <20%来定义ID似乎是最有效的,用于确定临床试验的高风险患者.
- 这种定义提供了与死亡率和住院治疗的强有力的关联,指导更好地选择患者进行干预.
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