Analysis of Iron Metabolism in Chronic Chagasic Cardiomyopathy

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.

摘要：心力衰竭（Heart Failure, HF）患者的铁代谢改变已被证实为重要的预后标志物。本研究旨在探讨铁动力学标志物是否与恰加斯心肌病（chagasic cardiomyopathy）的发病率及病因相关。研究共纳入三类受试者：慢性恰加斯心肌病（Chronic Chagasic Cardiomyopathy, CCC）患者40例、无症状型（indeterminate form, IND）恰加斯心肌病患者40例，以及非恰加斯心肌病（non-chagasic cardiomyopathy, NCh）患者40例。CCC组患者的平均年龄为50.98±5.88岁，男性占比50%；IND组患者平均年龄为49.68±5.28岁，男性占比52.2%；NCh组患者平均年龄为49.20±10.09岁，男性占比12.5%。与IND组（125.30±22.79）及NCh组（114.77±18.90）相比，CCC组的血清铁（Serum Iron, FeSe）水平更低（93.15±36.53，p=0.0004）；CCC组的转铁蛋白饱和度指数（transferrin saturation index, IST）为29.48±6.59，亦低于IND组（30.95±7.06）与NCh组（39.70±7.54，p=0.0001）；CCC组的总铁结合力（CTLF）为297.30±36.46，同样低于IND组（196.52±56.95）与NCh组（275.18±33.48，p=0.0001）；CCC组的铁蛋白中位数为134.55，四分位距为1.56~42.36，低于IND组的156.25（四分位距1.72~42.20）与NCh组的112.95（四分位距2.88~42.66，p=0.0004）。此外，研究还发现血清铁（Serum Iron, FeSe，95%置信区间1.00~1.04，p=0.0014）、转铁蛋白饱和度指数（transferrin saturation index, IST，95%置信区间1.02~1.22，p=0.0012）以及性别（95%置信区间1.07~14.43，p=0.0038）均与恰加斯心肌病患者的心室功能障碍程度独立相关。与无症状型恰加斯心肌病及其他类型心肌病相比，慢性恰加斯心肌病患者的铁代谢改变更为显著。