Iron Deficiency is Highly Prevalent in Patients with Pulmonary Arterial Hypertension

Abstract

Objective: The aim of this study was to assess the prevalence of iron deficiency in pulmonary hypertension, to compare it withother patient populations and to establish its prognostic value.Methods: This was a prospective, observational study. Serum iron parameters were measured in consecutive patients diagnosedwith pulmonary hypertension and compared with heart failure patients and healthy controls. A correlation was soughtbetween serum iron levels and functional class, distance walked in the 6-minute walk test and NT-proBNP.Results: A total of 107 patients were included in the study: 60 with pulmonary hypertension, 26 with heart failure and 21healthy controls. Iron deficiency was 78.3% in patients with pulmonary hypertension, 45.8% in those with heart failure and23.8% in healthy controls (p<0.001). The prevalence of anemia was 25% in pulmonary hypertension, 26.9% in heart failureand 19% in healthy controls (p<0.8). In patients with functional class I-II, iron deficiency was: 78% in pulmonary hypertensionvs. 43.5% in heart failure (p<0.005), and anemia was 17.1% vs. 28%, respectively (p<0.2). A significant correlation wasfound between serum iron and transferrin saturation with the distance walked in the 6-minute walk test (r: 0.35; p<0.01 andr: 0.34; p<0.01, respectively) and no correlation was found for transferrin and ferritin. Also, no significant correlation wasfound between iron deficiency and functional class or NT-proBNP.Conclusions: Iron deficiency is highly prevalent in pulmonary hypertension, and superior to that found in heart failure patientsand healthy controls. No relationship was established with anemia, which was similar in the three groups. Serum iron is clearlyrelated with the distance walked, but not with functional class, a result which may be attributed to the limited number of patients.Objetivos: Evaluar la prevalencia del déficit de hierro (DFe) en hipertensión pulmonar (HP) y compararlo con otras poblaciones de pacientes. Establecer su valor pronóstico. Materiales y Métodos: Estudio prospectivo, observacional. Se midieron parámetros de hierro sérico en pacientes consecutivos con diagnóstico de hipertensión pulmonar (HP). Se compararon con pacientes con insuficiencia cardiaca (IC) y con controles sanos (C). Se buscó correlación entre los valores séricos de hierro y la clase funcional, la distancia recorrida en TC6M y el NT-proBNP. Resultados: 107 pacientes: HP 60, IC 26, C 21. El DFe fue: HP 78,3%, IC 45,8%, C 23,8% (p 0,001), la prevalencia de anemia fue: HP 25%, IC 26,9%, C 19% (p 0,8). En el sub grupo de pacientes en CF 1-2 la prevalencia de DFe fue: HP 78% vs IC 43,5% (p 0,005) y la anemia: 17,1%% vs 28%% (p 0,2). Se halló correlación significativa entre Ferremia y Saturación de Transferrina con distancia caminada en TC6M (r 0,35; p 0,01 y r 0,34; p 0,01) y no hubo correlación para Ferritina y Transferrina. No se encontró significancia estadística entre DFe y CF o NT-proBNP. Conclusiones: El DFe en HP es altamente prevalente y superior al observado en IC y C, no estableciéndose relación con prevalencia de anemia, la cual fue similar en los tres grupos. El hierro sérico tiene una clara relación con la distancia caminada, no así con CF, lo que tal vez obedezca al bajo número de pacientes