Blood Viscosity and its Relationship to Iron Deficiency, Symptoms, and Exercise Capacity in Adults With Cyanotic Congenital Heart Disease

Broberg, Craig S.; Bax, Bridget E.; Okonko, Darlington O.; Rampling, M.W.; Bayne, Stephanie; Harries, Carl; Davidson, Simon; Uebing, Anselm; Khan, Arif Anis; Thein, Swee Lay; Gibbs, J. Simon R.; Burman, J. F.; Gatzoulis, Michael Α.

doi:10.1016/j.jacc.2006.03.040

Cited by 148 publications

(103 citation statements)

References 43 publications

(43 reference statements)

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“…While Tilmann and Schroter (1980) and Vaya et al (2005) reported decreased erythrocyte deformability, some other authors stating normal values (Reinhart 1992). Moreover iron deficiency has no effect on blood viscosity even in patients with cyanotic heart diseases (Broberg et al 2006). An explanation for autonomic dysfunction in iron deficiency anemia can be low oxygen tension in tissues.…”

Section: Discussionmentioning

confidence: 97%

The Altered Autonomic Nervous System Activity in Iron Deficiency Anemia

Yokuşoğlu

Nevruz

Baysan

et al. 2007

Tohoku J. Exp. Med.

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Section: Discussionmentioning

confidence: 97%

The Altered Autonomic Nervous System Activity in Iron Deficiency Anemia

Yokuşoğlu

Nevruz

Baysan

et al. 2007

Tohoku J. Exp. Med.

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“…Secondary erythrocytosis, commonly found in cyanotic CHD-PAH patients, represents a physiologic adaptation to improve oxygen delivery to the tissue [40]. As a consequence, routine phlebotomy is contraindicated as it impairs oxygen transport capacity, reduces exercise tolerance [41], induces iron deficient anemia [30] and augments the risk of stroke [42]. If unavoidable due to clear hyperviscosity symptoms, phlebotomy should only be performed in the absence of iron deficiency and by avoiding dehydration [40,43].…”

Section: Medical Therapy: General Aspectsmentioning

confidence: 99%

The challenge of managing pulmonary arterial hypertension in adults with congenital heart disease

Radke

Diller

Baumgartner

2013

Expert Review of Cardiovascular Therapy

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“…More than a third of CCHD patients are iron deficient [68][69][70]. Typical indices of iron deficiency including hypochromia and microcytosis are often absent; exclusion of iron deficiency, therefore, requires a complete iron metabolism workup, including serum ferritin and transferrin levels [68].…”

Section: Hematologic Consequences Of Cchdmentioning

confidence: 99%

“…Iron deficiency should be avoided in CCHD, with oral iron supplementation as needed to normalize ferritin levels remaining mindful of an overly robust rise in hematocrit [7]. Although physicians are often uncomfortable administering iron in patients with high hematocrit, supplementation has been shown to improve exercise capacity and quality of life in iron-deficient cyanotic patients without increasing hyperviscosity risk [69,72].…”

Section: Hematologic Consequences Of Cchdmentioning

confidence: 99%

Extra-cardiac manifestations of adult congenital heart disease

Gaeta

Ward

Krasuski

2016

Trends in Cardiovascular Medicine

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a b s t r a c tAdvancement in correction or palliation of congenital cardiac lesions has greatly improved the lifespan of congenital heart disease patients, resulting in a rapidly growing adult congenital heart disease (ACHD) population. As this group has increased in number and age, emerging science has highlighted the systemic nature of ACHD. Providers caring for these patients are tasked with long-term management of multiple neurologic, pulmonary, hepatic, renal, and endocrine manifestations that arise as syndromic associations with congenital heart defects or as sequelae of primary structural or hemodynamic abnormalities. In this review, we outline the current understanding and recent research into these extra-cardiac manifestations.Key words: Cardiovascular disease, Adult congenital heart disease, Pulmonary hypertension. Advances in the diagnosis and management of congenital heart disease (CHD) over the past several decades have greatly improved longevity and quality of life in the CHD population. Palliative or corrective interventions are now available for nearly every type of congenital cardiac lesion, and approximately 90% of affected children now survive to adulthood [1]. Adults with CHD (ACHD) already outnumber pediatric CHD patients, and this population is expected to grow by 5% per year [1,2]. Strikingly, the median age of severe CHD patients has increased from 11 years in 1985 to 25 years in 2010 [3]. Continued improvement in CHD interventions means that new (and more complex) populations will likely reach adulthood in the coming years.Practitioners who take care of adults with CHD are often charged with the delivery or coordination of comprehensive care for these complex patients, including the management of manifestations and complications that arise later in life. ACHD has many extra-cardiac effects, both as syndromic associations with congenital heart defects, or more commonly, as sequelae of primary structural or hemodynamic abnormalities. The role of genetic predilection remains undefined for nearly all extra-cardiac complications, though their incidence has clearly risen over the past decades. Indeed, more than a third of hospital admissions for ACHD patients are now for noncardiovascular reasons [4]. Optimal care of ACHD patients, therefore, mandates a thorough understanding of its multiorgan system manifestations. Herein, we will review current understanding of the most common manifestations of ACHD organized by the affected organ systems. Neurologic/neuropsychiatric Cerebrovascular complicationsA recent study quantified the strikingly high rates of stroke in ACHD [5]. Among nearly 30,000 ACHD patients, 8.9% of men http://dx

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Blood Viscosity and its Relationship to Iron Deficiency, Symptoms, and Exercise Capacity in Adults With Cyanotic Congenital Heart Disease

Cited by 148 publications

References 43 publications

The Altered Autonomic Nervous System Activity in Iron Deficiency Anemia

The Altered Autonomic Nervous System Activity in Iron Deficiency Anemia

The challenge of managing pulmonary arterial hypertension in adults with congenital heart disease

Extra-cardiac manifestations of adult congenital heart disease

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