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首页> 外文期刊>ESC Heart Failure >Left ventricular ejection fraction recovery in patients with heart failure treated with intravenous iron: a pilot study
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Left ventricular ejection fraction recovery in patients with heart failure treated with intravenous iron: a pilot study

机译：静脉铁剂治疗心力衰竭患者左心室射血分数恢复的初步研究

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Abstract Aims In patients with heart failure with reduced ejection fraction (HFrEF) and iron deficiency, treatment with intravenous iron has shown a clinical improvement regardless of anaemic status. Cardiac magnetic resonance (CMR) T2* sequence has shown a potential utility for evaluating myocardial iron deficiency. We aimed to evaluate whether T2* sequence significantly changes after ferric carboximaltose (FCM) administration, and if such changes correlate with changes in left ventricle ejection fraction (LVEF). Methods and results In this pilot study, we included eight patients with chronic symptomatic (New York Heart Association II?￠????III) HFrEF and iron deficiency. A CMR, including T2* analysis, was performed before and at a median of 43 days (interquartile range = 35?￠????48) after intravenous FCM administration. Pearson or Spearman correlation coefficient (r) was used for bivariate contrast as appropriate. A partial correlation analysis was performed between ????LVEF and ????T2* while controlling for anaemia status at baseline. Anaemia was present in half of patients. After FCM administration, T2* decreased from a median of 39.5 (35.9?￠????48) to 32 ms (32?￠????34.5), P = 0.012. Simultaneously, a borderline increase in median of LVEF [40% (36?￠????44.5) to 48.5% (38.5?￠????53), P = 0.091] was registered. In a bivariate correlational analysis, ????T2* was highly correlated with ????LVEF ( r = ?￠????0.747, P = 0.033). After controlling for anaemia at baseline, the association between ????T2* and ????LVEF persisted [ r (partial): ?￠????0.865, R 2 (partial): 0.748, P = 0.012]. A median regression analysis backed-up these findings. Conclusions In a small sample of patients with HFrEF and iron deficiency, myocardial iron repletion assessed by CMR was associated to left ventricular remodelling. Further studies are warranted.
机译：摘要目的对于射血分数降低且铁缺乏的心力衰竭患者，无论贫血状况如何，静脉铁剂治疗均显示出临床改善。心脏磁共振（CMR）T2 *序列已显示出评估心肌铁缺乏症的潜在用途。我们的目的是评估羧甲基铁（FCM）施用后T2 *序列是否显着改变，以及这种改变是否与左心室射血分数（LVEF）的改变相关。方法和结果在该初步研究中，我们纳入了8例患有慢性症状（纽约心脏协会II期– III期）HFrEF和铁缺乏症的患者。在静脉内给予FCM之前和之后的中位数为43天（四分位间距= 35≤≤48），进行了包括T2 *分析的CMR。皮尔逊或斯皮尔曼相关系数（r）用于适当的双变量对比。在控制基线时的贫血状态的同时，在βLVEF与βT2 *之间进行了部分相关性分析。一半的患者出现贫血。在给予FCM后，T2 *从中值39.5（35.9±48）降低到32ms（32±34.5），P ＝ 0.012。同时，记录了LVEF的中位数临界值增加[40％（36％≥44.5）至48.5％（38.5％≥53），P = 0.091]。在二元相关分析中，ΔT2 *与ΔLVEF高度相关（r ＝Δθ≥0.747，P ＝ 0.033）。在基线控制了贫血之后，ΔT2*和ΔLVEF之间的联系持续存在[r（部分）：Δ0.865，R 2（部分）：0.748，P ＝ 0.012]。中位数回归分析支持了这些发现。结论在少量HFrEF和铁缺乏症患者中，通过CMR评估的心肌铁补充与左心室重塑有关。值得进一步研究。

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