Iron deficiency is common in idiopathic pulmonary arterial hypertension

Abstract

The aims of this study were to assess the prevalence of iron deficiency in idiopathic pulmonary arterial hypertension (IPAH) and investigate whether oral iron supplementation has effects in iron-deficient patients.Iron parameters were measure for all IPAH patients attending our centre (VU University Medical Center, Amsterdam, the Netherlands) between May 2009 and February 2010. Iron data were related to clinical parameters, including 6-min walking distance (6MWD), and haemodynamic parameters measured during right heart catheterisation. In a subset of iron-deficient patients, the uptake of iron from the bowel was studied after administering oral iron for 4 weeks.Iron deficiency was found in 30 (43%) out of 70 patients. 6MWD was reduced in iron-deficient patients compared with iron-sufficient patients (mean¡SD 390¡138 versus 460¡143 m; p,0.05) irrespective of the existence of anaemia. In a subset of 18 patients that received oral iron, ferritin levels were significantly increased, although eight patients only slightly increased their iron storage.This study shows that iron deficiency is frequently present in IPAH and is associated with a lower exercise capacity. The small response to oral iron in 44% of the treated patients suggests impaired iron absorption in these patients.

Intravenous Iron Therapy in Patients with Idiopathic Pulmonary Arterial Hypertension and Iron Deficiency

“…In addition, in contrast to oral iron treatment, which does not produce a response in 44% of ID iPAH patients, ferric carboxymaltose led to higher iron stores in all patients, as represented by increased ferritin levels. 2 Figure 2. Oxygen handling in quadriceps muscle fibers after iron therapy in iron-deficient idiopathic pulmonary arterial hypertension patients.…”

“…5 We have shown that oral iron supplements are ineffective in restoring body iron stores in iPAH. 1,2 Recently, it was demonstrated that intravenous iron treatment in ID iPAH patients was associated with higher serum iron levels, improved 6-minute walk distance (6MWD), and quality of life. 6,7 However, the exact mechanisms by which iron improves clinical performance in iPAH patients remain to be elucidated.…”

“…[1][2][3] Compromised oxygen handlingthat is, oxygen transport and consumption at a skeletal muscle levelhas been suggested to cause the decreased exercise capacity in iron-deficient (ID) iPAH patients. 2,4 Furthermore, iron deficiency might lead to deterioration of right ventricular (RV) function. 5 We have shown that oral iron supplements are ineffective in restoring body iron stores in iPAH.…”

Pulmonary artery pressure and iron deficiency in patients with upregulation of hypoxia sensing due to homozygous VHLR200W mutation (Chuvash polycythemia)

“…5 These observations pointed to the possibility that iron status may influence the expression of pulmonary hypertension in Chuvash polycythemia as well. Furthermore, iron deficiency is common in patients with idiopathic pulmonary hypertension [15][16][17] and pulmonary hypertension secondary to cyanotic congenital heart disease, 18 and is associated with reduced exercise capacity. [16][17] Iron therapy improved exercise capacity in such patients.…”

“…Furthermore, iron deficiency is common in patients with idiopathic pulmonary hypertension [15][16][17] and pulmonary hypertension secondary to cyanotic congenital heart disease, 18 and is associated with reduced exercise capacity. [16][17] Iron therapy improved exercise capacity in such patients. 18 Congenital polycythemia is a rare disorder that occurs sporadically around the world.…”