Iron deficiency in patients with a Fontan circulation and its impact on exercise capacity.

IF 2.8 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Open Heart Pub Date : 2024-06-05 DOI:10.1136/openhrt-2024-002693

Gaston van Hassel, Sean C S Rivrud, Frank J Timmerman, Peter van der Meer, Elke S Hoendermis, Eryn T Liem, Rolf M F Berger, Joost P van Melle

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Abstract

Background: Iron deficiency (ID) has been reported in patients with congenital heart disease. There is, however, a scarcity of data on its prevalence in patients with a Fontan circulation. The aim of this study is to investigate the prevalence of ID in Fontan patients and to investigate the association between ID and exercise capacity in this population.

Methods and results: Blood count and haematological parameters were determined in plasma of 61 Fontan patients (51% female, mean age 29±9 years). ID was defined as transferrin saturation (TSAT) ≤19.8%. The prevalence of ID was 36% (22/61 patients). Especially among women, the diagnosis of ID was highly prevalent (52%) despite normal haemoglobin levels (153.7±18.4 g/L). Mean ferritin levels were 98±80 µg/L and mean TSAT levels were 22%±12%. Cardiopulmonary exercise testing was performed in 46 patients (75%). Patients with ID had a lower peak oxygen uptake (V̇O₂peak) (1397±477 vs 1692±530 mL/min; p=0.039), although this relationship was confounded by sex. The presence of ID increased the likelihood of not achieving a respiratory exchange ratio (RER) ≥1.1 by 5-fold (p=0.035).

Conclusion: ID is highly prevalent among patients with a Fontan circulation. V̇O₂peak is lower in patients with ID. Fontan patients with ID are less likely to achieve an RER≥1.1 during cardiopulmonary exercise testing.

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丰坦循环患者的铁缺乏症及其对运动能力的影响。

背景：据报道，先天性心脏病患者中存在铁缺乏症（ID）。然而，有关其在丰坦循环患者中发病率的数据却很少。本研究旨在调查缺铁症在丰坦患者中的发病率，并研究缺铁症与该人群运动能力之间的关系：方法和结果：对61名Fontan患者（51%为女性，平均年龄（29±9）岁）的血浆进行了血细胞计数和血液学参数测定。ID的定义是转铁蛋白饱和度（TSAT）≤19.8%。ID的发病率为36%（22/61名患者）。特别是在女性患者中，尽管血红蛋白水平正常（153.7±18.4 g/L），但ID的诊断率却很高（52%）。平均铁蛋白水平为 98±80 µg/L，平均 TSAT 水平为 22%±12%。46 名患者（75%）进行了心肺运动测试。ID患者的峰值摄氧量（V̇O2peak）较低（1397±477 vs 1692±530 mL/min；p=0.039），但这种关系受性别影响。ID的存在使呼吸交换比（RER）≥1.1的可能性增加了5倍（P=0.035）：结论：ID在丰坦循环患者中非常普遍。ID患者的V̇O2peak值较低。有ID的Fontan患者在心肺运动测试中达到RER≥1.1的可能性较低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Open Heart CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

4.60

自引率

3.70%

发文量

145

审稿时长

20 weeks

期刊介绍： Open Heart is an online-only, open access cardiology journal that aims to be “open” in many ways: open access (free access for all readers), open peer review (unblinded peer review) and open data (data sharing is encouraged). The goal is to ensure maximum transparency and maximum impact on research progress and patient care. The journal is dedicated to publishing high quality, peer reviewed medical research in all disciplines and therapeutic areas of cardiovascular medicine. Research is published across all study phases and designs, from study protocols to phase I trials to meta-analyses, including small or specialist studies. Opinionated discussions on controversial topics are welcomed. Open Heart aims to operate a fast submission and review process with continuous publication online, to ensure timely, up-to-date research is available worldwide. The journal adheres to a rigorous and transparent peer review process, and all articles go through a statistical assessment to ensure robustness of the analyses. Open Heart is an official journal of the British Cardiovascular Society.