Document Detail


Replacement therapy for iron deficiency improves exercise capacity and quality of life in patients with cyanotic congenital heart disease and/or the Eisenmenger syndrome.
MedLine Citation:
PMID:  20580108     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
INTRODUCTION: Iron deficiency is common in cyanotic congenital heart disease (CHD) and results in reduced exercise tolerance. Currently, iron replacement is advocated with limited evidence in cyanotic CHD. We investigated the safety and efficacy of iron replacement therapy in this population.
METHODS: Twenty-five iron-deficient cyanotic CHD patients were prospectively studied between August 2008 and January 2009. Oral ferrous fumarate was titrated to a maximum dose of 200mg thrice-daily. The CAMPHOR QoL questionnaire, 6minute walk test (6MWT) and cardiopulmonary exercise testing were conducted at baseline and after 3months of treatment.
RESULTS: Mean age was 39.9±10.9years, 80% females. Fourteen had Eisenmenger syndrome, 6 complex cyanotic disease and 5 Fontan circulation. There were no adverse effects necessitating termination of treatment. After 3months of treatment, hemoglobin (19.0±2.9g/dL to 20.4±2.7g/dL, p<0.001), ferritin (13.3±4.7μg/L to 54.1±24.2μg/L, p<0.001) and transferrin saturation (17.8±9.6% to 34.8±23.4%, p<0.001) significantly increased. Significant improvements were also detected in the total CAMPHOR score (20.7±10.9 to 16.2±10.4, p=0.001) and 6MWT distance (371.7±84.7m to 402.8.0±74.9m, p=0.001). Peak VO(2) remained unchanged (40.7±9.2% to 43.8±12.4% of predicted, p=0.15).
CONCLUSION: Three months of iron replacement therapy in iron-deficient cyanotic CHD patients was safe and resulted in significant improvement in exercise tolerance and quality of life. Identification of iron deficiency and appropriate replacement should be advocated in these patients.
Authors:
Edgar L W Tay; Ana Peset; Maria Papaphylactou; Ryo Inuzuka; Rafael Alonso-Gonzalez; Georgios Giannakoulas; Aphrodite Tzifa; Sara Goletto; Craig Broberg; Konstantinos Dimopoulos; Michael A Gatzoulis
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Publication Detail:
Type:  Journal Article     Date:  2010-07-01
Journal Detail:
Title:  International journal of cardiology     Volume:  151     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-09-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  307-12     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK.
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