title: Iron Deficiency in COPD Associates with Increased Pulmonary Artery Pressure Estimated by Echocardiography.
abstract: OBJECTIVE
  Iron deficiency (ID) might augment chronic pulmonary hypertension in chronic obstructive pulmonary disease (COPD). This observational study investigates the association between ID and systolic pulmonary artery pressure estimated by echocardiography in non-anaemic COPD outpatients.
  
  
  METHODS
  Non-anaemic COPD patients (GOLD II-IV) with no history of cardiovascular disease were recruited from outpatient clinics. Iron deficiency was defined as ferritin<100μg/L. Pulmonary artery pressure was estimated from the tricuspid regurgitation maximum velocity (TR Vmax). Tricuspid regurgitation Vmaxindicative of pulmonary hypertension was considered present for values ≥ 2.9 m/s.
  
  
  RESULTS
  In a total of 75 included patients, 31 (41%) had ID. These patients had a significantly higher TR Vmax(3.02 vs. 2.77 m/s, p=0.01) and lower diffusion capacity of carbon monoxide (40% vs. 50% of predicted, p<0.01), though similar in age, sex, pack years, FEV1and high-sensitive CRP (p>0.05). Ferritin inversely correlated with TR Vmaxin ID patients (-0.37 (p=0.04)). The prevalence of TR Vmax≥ 2.9 m/s was twice as high in patients with ID (58% vs. 29%) and odds ratio of pulmonary hypertension in ID (compared to no ID) was 3.3 (95% CI 1.3-8.6, p=0.015).
  
  
  CONCLUSIONS
  Iron deficiency in non-anaemic COPD patients was associated with a modest increase in systolic pulmonary artery pressure and limitation of diffusion capacity.
authors.affiliation: Department of Cardiology, Herlev Hospital, Copenhagen University Hospital, Herlev, Denmark. Electronic address: louislindplesner@gmail.com.
authors.forename: Louis L
authors.initials: LL
authors.lastname: Plesner
authors.affiliation: Department of Cardiology, Zealand University Hospital, Roskilde, Denmark.
authors.forename: Mikkel M
authors.initials: MM
authors.lastname: Schoos
authors.affiliation: Department of Cardiology, Herlev Hospital, Copenhagen University Hospital, Herlev, Denmark.
authors.forename: Morten
authors.initials: M
authors.lastname: Dalsgaard
authors.affiliation: Department of Clinical Biochemistry, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Jens P
authors.initials: JP
authors.lastname: Goetze
authors.affiliation: Department of Cardiology, Herlev Hospital, Copenhagen University Hospital, Herlev, Denmark.
authors.forename: Erik
authors.initials: E
authors.lastname: Kjøller
authors.affiliation: Centre for Respiratory Medicine and Allergy, Manchester Academic Health Science Centre, University Hospital South Manchester NHS Foundation Trust and the University of Manchester, Manchester, UK.
authors.forename: Jørgen
authors.initials: J
authors.lastname: Vestbo
authors.affiliation: Department of Cardiology, Herlev Hospital, Copenhagen University Hospital, Herlev, Denmark.
authors.forename: Kasper
authors.initials: K
authors.lastname: Iversen
mesh_terms: D000368:Aged; D001794:Blood Pressure; D004452:Echocardiography; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging / Q000503:physiopathology; D000090463:Iron Deficiencies; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D029424:Pulmonary Disease, Chronic Obstructive / Q000000981:diagnostic imaging / Q000503:physiopathology
keywords: Chronic obstructive pulmonary disease; Echocardiography; Ferritin; Iron deficiency; Pulmonary hypertension; Systolic pulmonary artery pressure