Cardiovascular function before and after iron therapy by echocardiography in patients with iron deficiency anemia.
BACKGROUND
The aim of the study was to estimate the left ventricular contractility using the ratio of left ventricular end-systolic wall stress to left ventricular end-systolic volume index in patients with iron deficiency anemia, for which there are no previous reports.


METHODS
Cardiovascular functions were evaluated using echocardiography and pulsed Doppler echocardiography in 30 children aged 3-14 years (hemoglobin 4.9-8.5 g/dL), before, during and after iron therapy. We also studied 38 healthy children as a control group.


RESULTS
The left ventricular preload was significantly higher and the left ventricular afterload was lower in the patients with anemia before iron therapy. The ratio of left ventricular end-systolic wall stress to left ventricular volume, an index of systolic function that is independent of preload and afterload, was significantly lower in the patients with anemia before iron therapy (before iron therapy 2.13 +/- 0.44, after therapy 3.52 +/- 0.76, healthy controls 3.42 +/- 0.70). Left ventricular early diastolic filling was significantly higher in the patients with anemia before iron therapy. The cardiac index was also significantly higher before therapy because of the increases in preload, heart rate and early diastolic filling, as well as the decrease of afterload. There were no significant differences in the indices of cardiovascular function between anemic patients after iron therapy compared with control subjects.


CONCLUSIONS
The ratio of left ventricular end-systolic wall stress to the left ventricular volume index and the cardiac index suggested that a hemoglobin concentration < or = 6 g/dL was associated with left ventricular dysfunction and circulatory congestion.
Hayashi
R
R
Department of Pediatrics, Nippon Medical School, Tokyo, Japan.
Ogawa
S
S
Watanabe
Z
Z
Yamamoto
M
M
D000293:Adolescent; D018798:Anemia, Iron-Deficiency / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015150:Echocardiography, Doppler; D005260:Female; D005296:Ferrous Compounds / Q000627:therapeutic use*; D006397:Hematinics / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D009200:Myocardial Contraction / Q000187:drug effects*; D013318:Stroke Volume / Q000187:drug effects*; D016277:Ventricular Function, Left / Q000187:drug effects*
D005296:Ferrous Compounds; D006397:Hematinics