肺动脉高压缺铁的影响、补充和未来方向

IF 1.2 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Arif Albulushi, Masoud Kashoub, Khalid Al-Saidi, Hatem Al-Farhan
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引用次数: 0

摘要

肺动脉高压(PH)是一种复杂的心血管疾病,其特点是肺动脉压力升高,会导致严重的发病率和死亡率。在影响 PH 病理生理学和进展的各种因素中,缺铁已成为一个关键因素,但却常常被忽视。在这篇综述中,将阐明 PH 患者缺铁的患病率、影响和治疗潜力。铁缺乏在相当一部分 PH 患者中普遍存在,与临床结果恶化有关,包括运动能力下降、氧运输和利用受损以及右心室功能受损。缺铁与 PH 之间的病理生理学联系是多方面的,涉及氧传感、内皮功能和代谢紊乱的改变。在本综述中,对近期临床试验和研究中的证据进行了批判性分析,这些试验和研究评估了口服和静脉补铁对 PH 预后的影响。尽管一些研究表明补铁后运动能力和血液动力学参数有所改善,但这些反应似乎各不相同,而且并非普遍有益。本综述强调了 PH 中铁代谢的复杂性,以及有效诊断和治疗这类患者缺铁所面临的挑战。此外,还讨论了补铁可能影响肺血管和右心室功能的潜在机制,强调了个性化治疗方法的必要性。本综述强调了在 PH 患者的治疗过程中识别铁缺乏症的重要性,并认为有必要开展进一步研究,为这一独特的患者群体制定全面、循证的补铁指南。本综述的最终目的是改善临床疗效,提高这一衰弱性疾病患者的生活质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Iron Deficiency in Pulmonary Hypertension Implications, Supplementation, and Future Directions

Pulmonary hypertension (PH) is a complex cardiovascular condition that is characterized by elevated pulmonary arterial pressure, which leads to significant morbidity and mortality. Among the various factors that influence the pathophysiology and progression of PH, iron deficiency has become a critical, yet often overlooked, element. In this review, the prevalence, implications, and therapeutic potential of addressing iron deficiency in patients with PH are elucidated.

Iron deficiency, which is prevalent in a significant proportion of patients with PH, has been associated with worsened clinical outcomes, including diminished exercise capacity, impaired oxygen transport and utilization, and compromised right ventricular function. The pathophysiological linkages between iron deficiency and PH are multifaceted and involve alterations in oxygen sensing, endothelial function, and metabolic disturbances.

In this review, the evidence from recent clinical trials and studies that assess the impact of iron supplementation, both oral and intravenous, on PH outcomes is critically analyzed. Although some studies suggest improvements in exercise capacity and hemodynamic parameters following iron repletion, the responses appear variable and are not universally beneficial. This review highlights the complexities of iron metabolism in PH and the challenges in effectively diagnosing and treating iron deficiency in this patient population.

Furthermore, the potential mechanisms through which iron supplementation might influence pulmonary vascular and right ventricular function, emphasizing the need for personalized treatment approaches are discussed. In this review, the importance of recognizing iron deficiency in the management of patients with PH is highlighted, and further research is warranted to establish comprehensive, evidence-based guidelines for iron supplementation in this unique patient cohort. The ultimate goal of this review is to improve clinical outcomes and quality of life for patients suffering from this debilitating condition.

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来源期刊
International heart journal
International heart journal 医学-心血管系统
CiteScore
2.50
自引率
6.70%
发文量
148
审稿时长
6-12 weeks
期刊介绍: Authors of research articles should disclose at the time of submission any financial arrangement they may have with a company whose product figures prominently in the submitted manuscript or with a company making a competing product. Such information will be held in confidence while the paper is under review and will not influence the editorial decision, but if the article is accepted for publication, the editors will usually discuss with the authors the manner in which such information is to be communicated to the reader.
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