Cohort study
Iron deficiency in pulmonary vascular disease: pathophysiological and clinical implications
- Cohort study
Authors' conclusion
The definition of iron deficiency in the 2022 European Society of Cardiology (ESC)/European Respiratory Society (ERS) pulmonary hypertension guidelines does not identify patients with lower exercise capacity or functional status, while a definition of TSAT <21% identifies patients with lower exercise capacity, worse functional status, right heart remodeling, and adverse clinical outcomes.
Study context
- Population
- Patients with pulmonary hypertension enrolled in the PVDOMICS study
- Participants
- 1,028 patients
- Exposure
- Transferrin saturation (TSAT) <21% vs TSAT ≥21%
Main finding
As reported in the abstract
Exercise capacity, functional status and mortality by TSAT
TSAT <21% vs TSAT ≥21%Absolute difference, mL/kg/min (CI)P value
peakVO2; adjusted for age, sex, hemoglobin
−1.89(−2.73 to −1.04)
P < 0.001TSAT <21% vs TSAT ≥21%Absolute difference, m (CI)P value
6-min walk test distance; adjusted for age, sex, hemoglobin
−34(−51 to −17)
P < 0.001TSAT <21% vs TSAT ≥21%Hazard ratio (95% CI)P value
mortality; adjusted for sex, age, hemoglobin, NT-proBNP
1.63(1.13–2.34)
P = 0.009- SF-36 physical component score; adjusted for age, sex, hemoglobin
- absolute difference −2.5 (CI −1.3 to −3.8); P < 0.001
Observational data: associations, not effects.
Further findings
HF definition of iron deficiency (guideline-endorsed)
- Did not identify patients with reduced peakVO2, 6-min walk test and SF-36
- P > 0.208 for all
Cardiac and pulmonary vascular structure
- TSAT <21%: more RV remodeling on CMR
- Similar pulmonary vascular resistance on catheterization
Original publication
Iron deficiency in pulmonary vascular disease: pathophysiological and clinical implications. Eur Heart J. Published 5 March 2023. doi:10.1093/eurheartj/ehad149
Summarised from the published abstract; every number is checked against it