The relationship between ferrokinetic parameters and the state of cardiac remodeling in patients with coronary artery disease with concomitant iron deficiency

Abstract

The aim of the study: to assess the relationship between ferrokinetic parameters and the state of cardiac remodeling in patients with coronary artery disease (CAD) depending on the stage of iron deficiency (ID). Materials and methods. The study involved 90 patients with CAD: stable angina pectoris II–III FC (35 men and 55 women, age – 69 (61; 72) years). All patients were divided into 4 clinical groups depending on the parameters of iron metabolism and hemogram: I (n = 16) – patients with absolute ID; II (n = 15) – with latent ID; III (n = 14) – with functional ID; IV (n = 45) – patients with CAD without iron metabolism disorders. The parameters of cardiac remodeling, iron metabolism and their relationship were analyzed. Results. During the analysis of ferrokinetic parameters, a decrease in transport (serum iron, transferrin saturation) and tissue (ferritin) reserve of iron on the background of an increase in the total and latent iron-binding capacity depending on the stage of sideropenia was established. At the same time, latent iron-binding capacity in patients with absolute ID was less by 43 % than in patients with latent ID. Patients with latent ID demonstrated a significantly higher level of transferrin saturation by 59.9 % than in the group of patients with CAD without concomitant ID. Patients with absolute ID, compared to patients without iron metabolism disorders, demonstrated significantly higher size of RAd by 14.18 % (U = 2.0; p < 0.05); increase EDVI of LV in 1.7 times (U = 4.0; p < 0.05); higher value of LV MI by 16 % (U = 17.0; p < 0.05). Also, patients with ferrokinetics disorders demonstrated a tendency to increase LVIDd, EDV LV, ESV LV, ESVI, LV mass, Ao, RAd, RVd, IVSd compared to patients without concomitant ID. For patients with absolute ID, it was established that there a relationship between the level of ferritin and IVSd (r = +0.84; p < 0.05); serum iron and LAd (r = -0.73; p < 0.05); total iron-binding capacity and Ao (r = -0.78; p < 0.05); latent iron-binding capacity and LVIDs (r = +0.71; p < 0.05). Patients with latent ID demonstrated relationships only between the transferrin saturation and LV MI (r = +0.60; p < 0.05). There were no statistically significant correlation relationships between indicators of iron metabolism and cardiac remodeling in patients with CAD and functional ID. Conclusions. The intensity of the processes of cardiac remodeling in patients with CAD and iron deficiency increases in direct proportion to the degree of progression of sideropenia, what is confirmed by the relevant correlation relationships.