Iron Metabolism Disorders

ABC

Brief Communication

Analysis of Iron Metabolism in Chronic Chagasic Cardiomyopathy

Carla Paixão Miranda et al. Fernando Antônio Botoni Maria do Carmo Pereira Nunes Manoel Otávio da Costa Rocha

Abstract

Changes in iron metabolism in heart failure (HF) have been described as an important prognostic marker.

To check if the markers of iron kinetics are related to the morbidity and etiology of chagasic cardiomyopathy.

Patients with Chronic Chagasic Cardiomyopathy (CCC, n = 40), with indeterminate form (IND, n = 40), besides non-chagasic cardiomyopathy (NCh, n = 40).

The mean age was 50.98 ± 5.88 in CCC, 50% were male, 49.68 ± 5.28 in IND, 52.2% were male, and 49.20 ± 10.09 in NCh, 12.5% were male. Lower levels of iron (FeSe) were observed in the CCC groups (93.15 ± 36.53), when compared to IND (125.30 ± 22.79) and NCh (114.77 ± 18.90) (p = 0.0004), lower IST transferrin saturation index in CCC (29.48 ± 6.59), when compared to IND (30.95 ± 7.06) and in the NCh group (39.70 ± 7.54) p = 0.0001), total binding capacity of the lower CTLF iron in the CCC group (297.30 ± 36.46), when compared to the IND group (196.52 ± 56.95) and the NCh group (275.18 ± 33, 48) (p = 0.0001), lower ferritin in the CCC group (134.55, 1.56-42.36), when compared to the IND group (156,25, 1,72-42,20) and the NCh group (112.95, 2.88-42.66) (p = 0.0004). It was also observed that FeSe (95% CI 1.00-1.04, p = 0.0014), IST (95% CI 1.02-1.22) (p = 0.0012) and gender (95% CI 1.07-14.43 p = 0.0038) were independently associated with the degree of ventricular dysfunction in chagasic cardiomyopathy.

CCC patients showed greater change in iron metabolism regarding the indeterminate form and other forms of cariomyopathies.

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ABC

Original Article

Prognostic Impact of Iron Metabolism Changes in Patients with Acute Coronary Syndrome

Tatiana Duarte et al. Sara Gonçalves Catarina Sá Rita Rodrigues … Rita Marinheiro Marta Fonseca Filipe Seixo Rui Caria

Abstract

Background:

Iron metabolism disorders have been associated with an increased risk of cardiovascular events. However, the prognostic impact on patients (pts) with acute coronary syndrome (ACS) has yet to be clarified.

Objective:

To determine the prognostic value of serum iron and ferritin levels in pts with ACS in the short and long-term.

Methods:

Consecutive pts admitted to a coronary care unit with a diagnosis of ACS, for a period of 2 years, were evaluated. The population was divided into tertiles of serum iron and ferritin distribution. The primary adverse events were the occurrence of in-hospital death or heart failure (HF) and death or HF at 1 year of follow-up.

Results:

We studied 280 pts (73% males; mean age 68 ± 13 years). The mean levels of serum iron and ferritin were 59 ± 34 mcg/dL and 205 ± 185 ng/mL, respectively. Patients included in the 1^st tertile of serum iron (≤ 40 mcg/dL) had a higher rate of adverse events, in-hospital and after 1 year. Lower and higher levels of ferritin (1^st and 3^rd tertiles, ≤ 110; >219 ng/ml, respectively) were associated with a higher incidence of HF during hospitalization and death at 1 year. A ferritin value >316 ng /mL was an independent risk factor for death at 1 year (adjusted OR: 14; 95%CI: 2.6 to 75.9).

Conclusion:

In this population, iron metabolism alterations were associated with a higher rate of adverse events and higher ferritin levels constituted an independent mortality predictor in the long-term.

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IJCS

Case Report

Hemochromatosis: Reversible Cause of Heart Failure

Cassia Pereira Kessler Iglesias et al. Paulo Vinicios Falcão Duarte Jacqueline Sampaio dos Santos Miranda Luana da Graça Machado Caio Ribeiro Alves Andrade

Introduction

GCW, age 33, presents acute heart failure (HF), amenorrhea and darkening of the skin. Three months after this initial situation, the patient is referred to a large cardiology centre and is submitted to HF screening, and the suspicion of hemochromatosis is promptly raised. This disease affects the heart in only 15% of cases. It has been shown that early recognition and intervention may change the prognosis. This is a diagnosis that should be considered in all cases of HF screening since it is easy to diagnose and its treatment can drastically change the prognosis of the disease.

Hereditary hemochromatosis (HH) is a genetic disease of iron metabolism characterized by increased intestinal absorption and progressive accumulation of it in different organs. HH is the most common autosomal disease in Caucasians, particularly those with Nordic or Celtic ancestors, affecting one in each 220-250 individuals. According to the mutations found, HH can be classified as: Hemochromatosis associated with HFE (classical hemochromatosis) and hemochromatosis not associated with HFE: Hereditary hemochromatosis due to mutation at the receptor 2 of transferrin-TfR2, juvenile hemochromatosis (hemojuvelin mutation – HJV gene and hepcidin mutation – HAMP gene), ferroportin disease and African iron overload. The vast majority (80-85%) of HH cases that have northern European ancestors are associated with HFE, while 10-15% of HH cases are not associated with HFE.

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Analysis of Iron Metabolism in Chronic Chagasic Cardiomyopathy

Abstract

Prognostic Impact of Iron Metabolism Changes in Patients with Acute Coronary Syndrome

Abstract

Background:

Objective:

Methods:

Results:

Conclusion:

Hemochromatosis: Reversible Cause of Heart Failure

Introduction

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