Alparslan KILIÇ, Betül CENGİZ ELÇİOĞLU, Saide AYTEKİN, Dilek URAL, Onur BAYDAR, Nihal TEFİK, Füsun HELVACI, Erol GÜRSOY, Yasemin DEMİRCİ, Vedat AYTEKİN

Effects of iron deficiency on left ventricular functions in young women regardless of anemia: A speckle tracking echocardiography study

Background/aim: Iron deficiency is one of the most common metabolic disorders worldwide and affects multiple organs and systems including the cardiovascular (CV) system. Iron deficiency can cause structural and functional changes in the myocardium. The aim of the study is to evaluate left ventricular (LV) functions in patients with low ferritin levels without anemia by two-dimensional “speckle tracking” echocardiography (2D STE). Materials and methods: We studied 90 participants (all female) that were divided into two groups according to ferritin levels (49 patients with ferritin levels 30 ng/mL). Patients with anemia (hemoglobin level

PDF

___

1. Looker AC. Iron deficiency—United States, 1999–2000, The Journal of the American Medical Association 2002; 288(17): 2114-2116. doi:10.1001/jama.288.17.2114-JWR1106-2-1
2. Miller JL. Iron deficiency anemia: a common and curable disease. Cold Spring Harbor Perspectives in Medicine 2013 Jul 1; 3(7): a011866. doi: 10.1101/cshperspect.a011866
3. Andrews NC. Disorders of iron metabolism. New England Journal of Medicine 1999; 341: 1986–95. doi: 10.1056/ nejm.199912233412607
4. Klip IT, Comin-Colet J, Voors AA, Ponikowski P, Enjuanes C et al. Iron deficiency in chronic heart failure: an international pooled analysis. American Heart Journal 2013; 165: 575–82. doi: 10.1016/j.ahj.2013.01.017
5. Okonko DO, Mandal AK, Missouris CG, Poole-Wilson PA. Disordered iron homeostasis in chronic heart failure: prevalence, predictors, and relation to anemia, exercise capacity, and survival. Journal of the American College of Cardiology 2011; 58: 1241–51. doi: 10.1016/j.jacc.2011.04.040
6. Jankowska EA, Von Haehling S, Anker SD, Macdougall IC, Ponikowski P. Iron deficiency and heart failure: diagnostic dilemmas and therapeutic perspectives. European Heart Journal 2013; 34: 816–829. doi: 10.1093/eurheartj/ehs224
7. Blayney L, Bailey-Wood R, Jacobs A, Henderson A, Muir J. The effects of iron deficiency on the respiratory function and cytochrome content of rat heart mitochondria. Circulation Research 1976; 39: 744–748. doi.org/10.1161/01.res.39.5.744
8. Finch CA, Miller LR, Inamdar AR, Person R, Seiler K et al. Iron deficiency in the rat. Physiological and biochemical studies of muscle dysfunction. Journal of Clinical Investigation 1976; 58: 447–453. doi:10.1172/JCI108489
9. Petering DH, Stemmer KL, Lyman S, Krezoski S, Petering HG. Iron deficiency in growing male rats: a cause of development of cardiomyopathy. Annals of Nutrition and Metabolism 1990; 34: 232-43. doi: 10.1159/000177592
10. Rineau E, Gaillard T, Gueguen N, Procaccio V, Henrion D et al. Iron deficiency without anemia is responsible for decreased left ventricular function and reduced mitochondrial complex I activity in a mouse model. International Journal of Cardiology 2018; 266: 206–212. doi: 10.1016/j.ijcard.2018.02.021
11. Dong F, Zhang X, Culver B, Chew HG, Kelley RO et al. Dietary iron deficiency induces ventricular dilation, mitochondrial ultrastructural aberrations and cytochrome c release: involvement of nitric oxide synthase and protein tyrosine nitration. Clinical Science 2005; 109: 277–286. doi:10.1042/ CS20040278
12. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. European Heart Journal of Cardiovascular Imaging 2015; 16: 233-271. doi: 10.1093/ehjci/ jev014
13. Feigenbaum H, Armstrong WF, Ayan T. Feigenbaum’s Echocardiography, 6th Ed. Lippincotts Williams&Wilkins 2005: pp. 355-356
14. Umbreit, J. Iron deficiency: A concise review. American Journal of Hematology 2005; 78: 225–231. doi: 10.1002/ajh.20249
15. Lopez A, Cacoub P, Macdougall IC, Peyrin-Biroulet L. Iron deficiency anaemia. Lancet 2016; 387: 907-916. doi: 10.1016/ S0140-6736(15)60865-0
16. Peyrin-Biroulet L, Williet N, Cacoub P. Guidelines on the diagnosis and treatment of iron deficiency across indications: A systematic review. American Journal of Clinical Nutrition 2015; 102(6): 1585–1594. doi: 10.3945/ajcn.114.103366
17. Cappellini MD, Comin-Colet J, de Francisco A, Dignass A, Doehner W et al. Iron deficiency across chronic inflammatory conditions: International expert opinion on definition, diagnosis, and management. American Journal of Hematology 2017; 92(10): 1068–1078. doi: 10.1002/ajh.24820
18. Silvestre OM, Gonçalves A, Nadruz W Jr, Claggett B, Couper D et al. Ferritin levels and risk of heart failure-the Atherosclerosis Risk in Communities Study. European Journal of Heart Failure 2017; 19(3): 340-347. doi: 10.1002/ejhf.701
19. Hoes MF, Grote Beverborg N, Kijlstra JD, Kuipers J, Swinkels DW. Iron deficiency impairs contractility of human cardiomyocytes through decreased mitochondrial function. European Journal of Heart Failure 2018; 20(5): 910-919. doi: 10.1002/ejhf.1154
20. Chvapil M, Hurych J, Ehrlichová E. The effect of iron deficiency on the synthesis of collagenous and non-collagenous proteins in wound granulation tissue and in the heart of rats. Experimental Medicine and Surgery 1968; 26(1-2): 52-60
21. Lederman HM, Cohen A, Lee JW, Freedman MH, Gelfand EW. Deferoxamine: a reversible S-phase inhibitor of human lymphocyte proliferation. Blood 1984; 64: 748–753
22. Zhou Q, Shen J, Liu Y, Luo R, Tan B et al. Assessment of left ventricular systolic function in patients with iron deficiency anemia by three-dimensional speckle-tracking echocardiography. Anatolian Journal of Cardiology 2017; 18(3): 194-199. doi: 10.14744/AnatolJCardiol.2017.7694
23. Shen J, Zhou Q, Liu Y, Luo R, Tan B et al. Evaluation of left atrial function in patients with iron-deficiency anemia by two-dimensional speckle tracking echocardiography. Cardiovascular Ultrasound 2016; 14(1): 34. doi: 10.1186/ s12947-016-0078-z