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Abstract：
OBJECTIVE: We aimed to investigate the prevalence of iron deficiency (ID) in congenital heart disease associated with pulmonary arterial hypertension (CHD-PAH) and to explore the influence of ID on CHD-PAH patients. What was associated with ID in these patients was also looked into.
METHODS: One hundred and fifty-three patients who were newly diagnosed with CHD-PAH were enrolled. Patients were divided into iron-deficient and iron-replete groups according to the following criteria. ID was defined as transferrin saturation <20% in male and transferrin saturation <25% in female. Clinical data of all participants were collected and compared. Logistic regression was performed to explore factors associated with ID in CHD-PAH.
RESULTS: Thirty-nine percent of 153 CHD-PAH patients were founded with ID. Iron-deficient group had greater proportion of female patients, shorter six minutes walking distance (6-MWD), higher N-terminal pro-brain natriuretic peptide levels, lower creatinine levels, greater ratio of diastolic right ventricle diameter to left ventricle diameter. Female (OR = 15.44, 95%CI 4.91-48.54, p < .01), 6-MWD (OR = 0.99, 95%CI 0.98-1.00, p = .02) and mean right atrial pressure (OR = 1.13, 95%CI 1.02-1.26, p = .02) were independently associated with ID in the overall CHD-PAH patients. Menstruation was independently associated with ID in the female subgroup (OR = 3.88, 95%CI 1.09-13.84, p = .04).
CONCLUSIONS: ID was highly prevalent in CHD-PAH patients. Worse exercise tolerance and right heart function were observed in iron-deficient patients with CHD-PAH. Female, 6-MWD, mean right atrial pressure and menstruation are important variables indicating the presence of ID in CHD-PAH.
METHODS: One hundred and fifty-three patients who were newly diagnosed with CHD-PAH were enrolled. Patients were divided into iron-deficient and iron-replete groups according to the following criteria. ID was defined as transferrin saturation <20% in male and transferrin saturation <25% in female. Clinical data of all participants were collected and compared. Logistic regression was performed to explore factors associated with ID in CHD-PAH.
RESULTS: Thirty-nine percent of 153 CHD-PAH patients were founded with ID. Iron-deficient group had greater proportion of female patients, shorter six minutes walking distance (6-MWD), higher N-terminal pro-brain natriuretic peptide levels, lower creatinine levels, greater ratio of diastolic right ventricle diameter to left ventricle diameter. Female (OR = 15.44, 95%CI 4.91-48.54, p < .01), 6-MWD (OR = 0.99, 95%CI 0.98-1.00, p = .02) and mean right atrial pressure (OR = 1.13, 95%CI 1.02-1.26, p = .02) were independently associated with ID in the overall CHD-PAH patients. Menstruation was independently associated with ID in the female subgroup (OR = 3.88, 95%CI 1.09-13.84, p = .04).
CONCLUSIONS: ID was highly prevalent in CHD-PAH patients. Worse exercise tolerance and right heart function were observed in iron-deficient patients with CHD-PAH. Female, 6-MWD, mean right atrial pressure and menstruation are important variables indicating the presence of ID in CHD-PAH.
摘要：
目的：探讨先天性心脏病合并肺动脉高压(CHD-PAH)患者缺铁(ID)的发生率及ID对CHD-PAH患者的影响。还研究了这些患者中与ID相关的内容。
方法：纳入新诊断为CHD-PAH的153例患者。根据以下标准将患者分为缺铁组和铁充足组。ID定义为男性中转铁蛋白饱和度<20%,女性中转铁蛋白饱和度<25%。收集并比较所有参与者的临床资料。采用Logistic回归分析探讨CHD-PAH与ID相关的因素。
结果：153例CHD-PAH患者中有39%是ID。缺铁组女性患者比例更高，较短的六分钟步行距离（6-MWD），较高的N末端脑钠肽前体水平，较低的肌酐水平，舒张期右心室直径与左心室直径的比值更大。女性（OR=15.44，95CI4.91-48.54，p<0.01），6-MWD（OR=0.99，95CI0.98-1.00，p=.02）和平均右心房压（OR=1.13，95CI1.02-1.26，p=.02）与冠心病患者的ID独立相关。女性亚组月经与ID独立相关(OR=3.88,95CI1.09-13.84,p=.04)。
结论：ID在CHD-PAH患者中非常普遍。在缺乏铁的CHD-PAH患者中观察到更差的运动耐量和右心功能。女性,6-MWD,平均右心房压和月经是表明CHD-PAH中存在ID的重要变量。
方法：纳入新诊断为CHD-PAH的153例患者。根据以下标准将患者分为缺铁组和铁充足组。ID定义为男性中转铁蛋白饱和度<20%,女性中转铁蛋白饱和度<25%。收集并比较所有参与者的临床资料。采用Logistic回归分析探讨CHD-PAH与ID相关的因素。
结果：153例CHD-PAH患者中有39%是ID。缺铁组女性患者比例更高，较短的六分钟步行距离（6-MWD），较高的N末端脑钠肽前体水平，较低的肌酐水平，舒张期右心室直径与左心室直径的比值更大。女性（OR=15.44，95CI4.91-48.54，p<0.01），6-MWD（OR=0.99，95CI0.98-1.00，p=.02）和平均右心房压（OR=1.13，95CI1.02-1.26，p=.02）与冠心病患者的ID独立相关。女性亚组月经与ID独立相关(OR=3.88,95CI1.09-13.84,p=.04)。
结论：ID在CHD-PAH患者中非常普遍。在缺乏铁的CHD-PAH患者中观察到更差的运动耐量和右心功能。女性,6-MWD,平均右心房压和月经是表明CHD-PAH中存在ID的重要变量。
