Left ventricular systolic function in patients with myocardial infarction and iron deficiency during correction with iron supplements

Abstract

BACKGROUND: Iron deficiency is associated with worse contractile function of the heart in patients after myocardial infarction.

AIM: To study the contractile function of the left ventricle in patients with myocardial infarction and iron deficiency for 12 months while taking iron supplements.

MATERIAL AND METHODS: The study included 83 patients with myocardial infarction and iron deficiency. The average age was 62.0±11 years. The patients underwent drug correction of iron deficiency by parenteral administration of iron carboxymaltose or oral administration of iron sulfate. After 3 months, the patients were divided into two groups depending on the compensation of iron deficiency. The first group consisted of 58 (70%) patients with compensated iron deficiency, the second group — 25 (30%) patients with persistent deficiency. The patients underwent echocardiography with assessment of the left ventricular ejection fraction and the total index of its myocardial mobility in the first 24 hours after hospitalization, after 3, 6 and 12 months. Comparison of mean values was performed using the Mann–Whitney U-test. Differences in indicators were considered statistically significant at p <0.05.

RESULTS: In the first 24 hours after hospitalization for myocardial infarction, the ejection fraction did not differ in patients: in the first group — 48% [45; 54], in the second — 53% [48; 54] (p=0.07). In the first group, an increase in the ejection fraction was found compared to the baseline value: 53% [46; 58] (p <0.001) 6 months after myocardial infarction, 55% [48; 58] (p <0.001) after 12 months. In the second group, the ejection fraction after 3, 6 and 12 months did not differ from the baseline. The total myocardial mobility index on the 1st day after myocardial infarction did not differ between the groups: 1.25 [1.19; 1.62] in the first group and 1.25 [1.12; 1.56] in the second group (p=0.3). Its decrease was found in the first group: 1.19 [1.06; 1.56] (p <0.001) after 6 months and 1.12 [1.0; 1.44] (p <0.001) after 12 months. In the second group, the values of the total myocardial mobility index after 3, 6 and 12 months did not differ from the initial ones.

CONCLUSION: Iron deficiency compensation is associated with improved left ventricular systolic function within 12 months after myocardial infarction.

Keywords

iron deficiency / myocardial infarction / left ventricular systolic function

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