Parameters of intracardiac hemodynamics in iron deficiency in patients with chronic heart failure

BACKGROUND: Iron deficiency is a common comorbidity in many patients with chronic heart failure.

AIM: To study the parameters of intracardiac hemodynamics in the patients with chronic heart failure in the presence of iron deficiency.

MATERIALS AND METHODS: We examined 179 patients (36 men and 143 women, mean age 71.6 ± 7.9 years) with heart failure of functional class 2-4 (NYHA). All the patients underwent a clinical examination, a 6-minute walk test, a general blood test; the level of NT-proBNP, iron, transferrin, and ferritin in blood serum were studied; the percentage of transferrin saturation with iron was calculated. The presence of iron deficiency was assessed based on a decrease in the level of serum ferritin less than 100 μg/L or ferritin ranging from 100 to 299 μg/L and saturation of transferrin with iron less than 20%. All the patients underwent echocardiography in one-dimensional, two-dimensional and Doppler modes (pulse-wave, constant-wave and tissue) in standard positions according to the generally accepted technique.

RESULTS: It was found that in the patients with chronic heart failure and iron deficiency compared with the patients without iron deficiency; the end systolic volume of the left ventricle, the size of the right ventricle and the systolic pressure in the pulmonary artery were significantly higher, and the speed of movement of the fibrous ring of the mitral and tricuspid valves and the working capacity were lower. Significant correlations were established between the concentration of iron and ferritin and the parameters of intracardiac hemodynamics.

CONCLUSIONS: Iron deficiency in the patients with chronic heart failure without anemia contributes to an early initial decrease in cardiac contractility with an intact ejection fraction.