3 years ago

Iron Laboratory Studies in Pediatric Patients with Heart Failure From Dilated Cardiomyopathy

Iron deficiency (FeD), with or without anemia, in adults with heart failure (HF) is associated with poor outcomes, which can be improved with replacement therapy. A similar therapeutic opportunity may exist for children; however, iron laboratory measurements and FeD have not been described in pediatric patients with HF. A single-center, retrospective study was conducted on 28 patients <21 years old with a diagnosis of dilated cardiomyopathy and HF who had iron labs (serum iron, iron saturation (Tsat), and ferritin) performed. The mean (SD) age at time of lab collection was 10.3 (5.5) years. Twenty-seven patients (96.4%) met the criteria for FeD. Serum iron and Tsat were significantly associated with inpatient hospitalization, being on inotropic medications or having stage D HF. Low serum iron was associated with a higher Left Ventricular End Diastolic Dimension (LVEDD) and Left Ventricular End Systolic Dimension (LVESD) Z-score by echocardiography ((β, -2.58; 95% CI, -4.76,-0.40, p=0.02) and (β, -2.43; 95% CI -4.70,-0.17, p=0.04)), respectively. Low ferritin was associated with higher mortality (RR, 0.29; 95% CI, 0.12,0.70, p=0.006). In conclusion, FeD was common in this pediatric cohort with more advanced HF. Iron profile abnormalities were associated with worse HF severity and outcomes including mortality.

Publisher URL: www.sciencedirect.com/science

DOI: S0002914917313930

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