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Year : 2018  |  Volume : 17  |  Issue : 1  |  Page : 22-28

The effects of ferrous sulfate as an iron supplement on ejection fraction in patients with iron deficiency anemia associated with decompensated heart failure

Department of Pharmacology, College of Medicine, University of Baghdad, Baghdad, Iraq

Correspondence Address:
Dr. Mohammed Qasim Yahya Mal-Allah Al-Atrakji
Department of Pharmacology, College of Medicine, University of Baghdad, Baghdad
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/MJ.MJ_6_18

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Background: Acute decompensated heart failure (HF) is a clinical syndrome that results when abnormalities in the structure and function of the myocardium impair cardiac output or decrease filling of the ventricles. Anemia is a common comorbidity in patients with chronic HF (CHF), is associated with increased disease severity, and may contribute to a worse the outcome. Aim of the Study: To study the relationship between iron level and left ventricular function (LVF) in patients having acute decompensated HF and the effects of iron supplement on this function. Patients and Methods: This cross-sectional study was conducted in the medical wards of Baghdad Teaching Hospital at different times during the period between October 1, 2016, and May 1, 2017. It included 60 patients diagnosed with CHF (9 patients with HF with preserved ejection fraction [EF] and 51 patients with HF with reduced EF) and admitted to the medical wards due to acute decompensation. For all patients, history, cardiological examination, New York Heart Association classification, electrocardiogram, and chest X-ray were done. Body mass index was measured. Standard echocardiography was performed. Hematological parameters were measured including hemoglobin (Hb), mean corpuscular volume, mean corpuscular Hb (MCH), MCH concentration, blood film, serum iron, erythrocyte count, total iron-binding capacity, and transferrin saturation. Results: Serum iron was significantly lower in patients with impaired EF with median serum iron 41 versus 94 mcg/dL in preserved EF (72.5% vs. 0%). Transferrin saturation was statistically and significantly lower in patients with EF <50% (39.2% of the patients with impaired EF had low transferrin saturation [P < 0.001] compared to 0% in patients with preserved EF). EF had inverse significant correlation with total binding capacity of iron (r = −0.585, P < 0.001). Iron supplements as ferrous sulfate have a highly significant effect (P < 0.001) on improving the LVF and EF, iron level and transferrin saturation in patients with decompensated HF with low EF. Conclusions: Most HF patients with low EF in this study had reduced iron level and transferrin saturation comparing to those with preserved EF. Iron supplement in a patient with low EF preserved the EF in them. Anemia still is founded in patients of HF with acceptable EF in the presence of normal iron status, and this is explained by other causes rather than iron deficiency.

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