Iron Deficiency in COPD Associates with Increased Pulmonary Artery Pressure Estimated by Echocardiography
Iron Deficiency in COPD Associates with Increased Pulmonary Artery Pressure Estimated by Echocardiography
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DOI：
10.1016/j.hlc.2016.04.020
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发表时间：
2017-01-01
影响因子：
2.6
通讯作者：
Iversen, Kasper
中科院分区：
文献类型：
--
作者：
Plesner, Louis L.;Schoos, Mikkel M.;Iversen, Kasper
目的：铁缺乏（ID）可能加重慢性阻塞性肺疾病（COPD）患者的慢性肺动脉高压。这项观察性研究调查了非贫血性COPD门诊患者超声心动图估计的ID和收缩期肺动脉压之间的关系。方法从门诊招募无心血管病史的非贫血性COPD患者（GOLD II-IV）。缺铁定义为铁蛋白< 100 μ g/L。肺动脉压由三尖瓣最大反流速度（TR V-max）估算。三尖瓣返流Vmax值>= 2.9 m/s时，认为存在肺动脉高压。结果纳入的75例患者中，有31例（41%）有ID。这些患者的年龄、性别、包龄、FEV1和高敏CRP相似，但其TR Vmax （3.02 vs. 2.77 m/s, p= 0.01）和一氧化碳扩散能力（40% vs. 50%, p< 0.01）均显著升高（p < 0.05）。ID患者铁蛋白与TR V-max呈负相关（-0.37 (p= 0.04)）。肺心病患者的TR V-max > 2.9 m/ s患病率是肺心病患者的两倍（58% vs. 29%），肺心病患者肺动脉高压（与无肺心病患者相比）的优势比为3.3 （95% CI 1.3 ~ 8.6, p= 0.015）。结论：非贫血性COPD患者缺铁与收缩期肺活量的适度增加有关
Objectives 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.Methods Non-anaemic COPD patients (GOLD II-IV) with no history of cardiovascular disease were recruited from outpatient clinics. Iron deficiency was defined as ferritin < 100 mu g/L. Pulmonary artery pressure was estimated from the tricuspid regurgitation maximum velocity (TR V-max). Tricuspid regurgitation Vmax indicative of pulmonary hypertension was considered present for values >= 2.9 m/s.Results In 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 V-max in ID patients (-0.37 (p= 0.04)). The prevalence of TR V-max > 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).Conclusion Iron deficiency in non-anaemic COPD patients was associated with a modest increase in systolic pulmonary