Iron Deficiency in COPD Associates with Increased Pulmonary Artery Pressure Estimated by Echocardiography

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• 作者：Louis L. Plesner ; MB^a ; ^{louislindplesner@gmail.com} ; Mikkel M. Schoos ; MD ; PhD^b ; Morten Dalsgaard ; MD ; PhD^a ; Jens P. Goetze ; MD ; DMSc^c ; Erik Kjø ; ller ; MD ; DMSc^a ; Jø ; rgen Vestbo ; MD ; DMSc^d ; Kasper Iversen ; MD ; DMSc^a
• 关键词：Chronic obstructive pulmonary disease ; Iron deficiency ; Pulmonary hypertension ; Echocardiography ; Systolic pulmonary artery pressure ; Ferritin
• 刊名：Heart, Lung and Circulation
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：26
• 期：1
• 页码：101-104
• 全文大小：265 K
• 卷排序：26

文摘

Iron deficiency (ID) might augment chronic pulmonary hypertension in chronic obstructive pulmonary disease (COPD). This observational study investigates the association between ID and systolic pulmonary artery pressure estimated by echocardiography in non-anaemic COPD outpatients.MethodsNon-anaemic COPD patients (GOLD II-IV) with no history of cardiovascular disease were recruited from outpatient clinics. Iron deficiency was defined as ferritin < 100 μg/L. Pulmonary artery pressure was estimated from the tricuspid regurgitation maximum velocity (TR Vmax). Tricuspid regurgitation Vmax indicative of pulmonary hypertension was considered present for values ≥ 2.9 m/s.ResultsIn a total of 75 included patients, 31 (41%) had ID. These patients had a significantly higher TR Vmax (3.02 vs. 2.77 m/s, p=0.01) and lower diffusion capacity of carbon monoxide (40% vs. 50% of predicted, p<0.01), though similar in age, sex, pack years, FEV1 and high-sensitive CRP (p>0.05). Ferritin inversely correlated with TR Vmax in ID patients (-0.37 (p=0.04)). The prevalence of TR Vmax ≥ 2.9 m/s was twice as high in patients with ID (58% vs. 29%) and odds ratio of pulmonary hypertension in ID (compared to no ID) was 3.3 (95% CI 1.3-8.6, p=0.015).ConclusionIron deficiency in non-anaemic COPD patients was associated with a modest increase in systolic pulmonary artery pressure and limitation of diffusion capacity.