- 作者：Mario Kasner ; Aleks ; ar S. Aleks ; rov ; Dirk Westermann ; Dirk Lassner ; Michael Gross ; Stephan von Haehling ; Stefan D. Anker ; Heinz-Peter Schultheiss ; Carsten Tsch枚pe
- 关键词：尾 ; constant of LV stiffness ; exponential curve fit to EDPVR ; CO ; cardiac output ; dP/dtmax ; maximum rate of LV pressure change ; dP/dtmin ; minimum rate of LV pressure change ; E/A ; ratio of early peak (E) to late peak (A) mitral flow velocities ; E/E&prime ; LV filling index ; E&prime ; /A&prime ; early (E&prime ; ) to late (A&prime ; ) diastolic velocity ratio of mitral annulus ; EDV ; end-diastolic volume ; EDPVR ; end-diastolic pressure&ndash ; volume relationship ; EF ; ejection fraction ; ESP ; end-systolic pr
- 刊名：International Journal of Cardiology
- 出版年：12 October, 2013
- 年：2013
- 卷：168
- 期：5
- 页码：4652-4657
- 全文大小：422 K
Background
Functional iron deficiency (FID) is an independent risk factor for poor outcome in advanced heart failure with reduced EF, but its role in heart failure with preserved EF (HFPEF) remains unclear. We aimed to investigate the impact of FID on cardiac performance determined by pressure-volume loop analysis in HFPEF.Methods
26 HFPEF patients who showed an increase in LV stiffness by pressure-volume (PV) loop analysis obtained by conductance-catheterization, performed exercise testing, echocardiographic examination including tissue Doppler and determination of iron metabolism: serum iron, ferritin and transferrin saturation. HFPEF patients who provided ferritin < 100 渭g/l or ferritin of 100-299 渭g/l in combination with transferrin saturation < 20% were defined as having FID. In 14 patients the expression of transferrin receptor was determined from available endomyocardial biopsies.
Results
Fifteen out of 26 HFPEF patients showed FID without anemia. Compared to control subjects and HFPEF patients without FID, HFPEF patients with FID showed an up-regulation of the myocardial transferrin receptor expression (p < 0.05). No differences between HFPEF patients with and without iron deficiency were found in heart dimensions, systolic and diastolic function obtained by PV-loop and echocardiography analysis. According to the linear regression analysis, LV stiffness was correlated with peak oxygen uptake (r = 鈭?#xA0;0.636, p < 0.001) but not with the ferritin level or transferrin saturation. No relation was found between FID and exercise capacity. The association of LV stiffness with exercise performance was independent from the level of iron deficiency.
Conclusion
In non-anemic HFPEF patients, cardiac dysfunction and impaired exercise capacity occur independently of FID.