Iron deficiency is common in idiopathic pulmonary arterial hypertension

• Published in: The European respiratory journal Vol. 37; no. 6; pp. 1386 - 1391
• Main Authors: RUITER, G, LANKHORST, S, BOONSTRA, A, POSTMUS, P. E, ZWEEGMAN, S, WESTERHOF, N, VAN DER LAARSE, W. J, VONK-NOORDEGRAAF, A
• Format: Journal Article
• Language: English
• Published: Leeds Maney 01.06.2011
• Subjects: Adult; Aged; Anemias. Hemoglobinopathies; Biological and medical sciences; Cardiac Catheterization; Dietary Supplements; Diseases of red blood cells; Exercise Test; Familial Primary Pulmonary Hypertension; Female; Ferritins - blood; Hematologic and hematopoietic diseases; Humans; Hypertension, Pulmonary - epidemiology; Iron - deficiency; Iron - therapeutic use; Male; Medical sciences; Metabolic diseases; Metals (hemochromatosis...); Middle Aged; Other metabolic disorders; Pneumology; Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases; Physical exercise; Respiratory disease; Iron deficiency anemia; Idiopathic; Metabolic diseases; Cardiovascular disease; Hemopathy; Iron; Inorganic element; Artery; Pulmonary hypertension; Capacity; iron deficiency; Sideropenia; Exercise capacity; Pneumology
• DOI: 10.1183/09031936.00100510
• ISSN: 0903-1936

The aims of this study were to assess the prevalence of iron deficiency in idiopathic pulmonary arterial hypertension (IPAH) and investigate whether oral iron supplementation has effects in iron-deficient patients. Iron parameters were measure for all IPAH patients attending our centre (VU University Medical Center, Amsterdam, the Netherlands) between May 2009 and February 2010. Iron data were related to clinical parameters, including 6-min walking distance (6MWD), and haemodynamic parameters measured during right heart catheterisation. In a subset of iron-deficient patients, the uptake of iron from the bowel was studied after administering oral iron for 4 weeks. Iron deficiency was found in 30 (43%) out of 70 patients. 6MWD was reduced in iron-deficient patients compared with iron-sufficient patients (mean±sd 390±138 versus 460±143 m; p<0.05) irrespective of the existence of anaemia. In a subset of 18 patients that received oral iron, ferritin levels were significantly increased, although eight patients only slightly increased their iron storage. This study shows that iron deficiency is frequently present in IPAH and is associated with a lower exercise capacity. The small response to oral iron in 44% of the treated patients suggests impaired iron absorption in these patients.