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Iron deficiency in patients with a Fontan circulation and its impact on exercise capacity.

Authors :
van Hassel G
Rivrud SCS
Timmerman FJ
van der Meer P
Hoendermis ES
Liem ET
Berger RMF
van Melle JP
Source :
Open heart [Open Heart] 2024 Jun 05; Vol. 11 (1). Date of Electronic Publication: 2024 Jun 05.
Publication Year :
2024

Abstract

Background: Iron deficiency (ID) has been reported in patients with congenital heart disease. There is, however, a scarcity of data on its prevalence in patients with a Fontan circulation. The aim of this study is to investigate the prevalence of ID in Fontan patients and to investigate the association between ID and exercise capacity in this population.<br />Methods and Results: Blood count and haematological parameters were determined in plasma of 61 Fontan patients (51% female, mean age 29±9 years). ID was defined as transferrin saturation (TSAT) ≤19.8%. The prevalence of ID was 36% (22/61 patients). Especially among women, the diagnosis of ID was highly prevalent (52%) despite normal haemoglobin levels (153.7±18.4 g/L). Mean ferritin levels were 98±80 µg/L and mean TSAT levels were 22%±12%. Cardiopulmonary exercise testing was performed in 46 patients (75%). Patients with ID had a lower peak oxygen uptake (V̇O <subscript>2</subscript> peak) (1397±477 vs 1692±530 mL/min; p=0.039), although this relationship was confounded by sex. The presence of ID increased the likelihood of not achieving a respiratory exchange ratio (RER) ≥1.1 by 5-fold (p=0.035).<br />Conclusion: ID is highly prevalent among patients with a Fontan circulation. V̇O <subscript>2</subscript> peak is lower in patients with ID. Fontan patients with ID are less likely to achieve an RER≥1.1 during cardiopulmonary exercise testing.<br />Competing Interests: Competing interests: RMFB: The University Medical Center Groningen contracts with Janssen, MSD and GSK for steering committee and advisory board committee activities of RMFB, outside the scope of this manuscript.<br /> (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Details

Language :
English
ISSN :
2053-3624
Volume :
11
Issue :
1
Database :
MEDLINE
Journal :
Open heart
Publication Type :
Academic Journal
Accession number :
38839367
Full Text :
https://doi.org/10.1136/openhrt-2024-002693