Kazan medical journalKazan medical journalКазанский медицинский журнал0368-48142587-9359Eco-Vector63498010.17816/KMJ634980Theoretical and clinical medicineТеоретическая и клиническая медицинаResearch ArticleLeft ventricular systolic function in patients with myocardial infarction and iron deficiency during correction with iron supplementsСистолическая функция левого желудочка у пациентов с инфарктом миокарда и дефицитом железа на фоне коррекции препаратами железаhttps://orcid.org/0000-0002-5501-21787520-1188KhastievaDilyara R.ХастиеваДиляра Ринатовна
Russian Federation

Ass. Prof., Depart. of Propaedeutics of Internal Diseases named after Prof. S.S. Zimnitsky

асс., каф. пропедевтики внутренних болезней им. проф. С.С. Зимницкого

dilyara_khastieva@mail.ruhttps://orcid.org/0000-0003-0024-98297442-1723TarasovaNatalia A.ТарасоваНаталья Алексеевна
Russian Federation

Postgrad. Stud., Depart. of Propaedeutics of Internal Diseases named after Prof. S.S. Zimnitsky

асп., каф. пропедевтики внутренних болезней им. проф. С.С. Зимницкого

aleks37@yandex.ruhttps://orcid.org/0000-0003-3707-65119818-5421ValeevaIldaria K.ВалееваИлдария Хайрулловна
Russian Federation

Dr. Sci. (Biol.), Senior Researcher, Central Research Laboratory

д-р биол. наук, с.н.с., центральная научно-исследовательская лаборатория

ildaria.valeeva@yandex.ruhttps://orcid.org/0000-0002-7760-07632501-3397KhasanovNiyaz R.ХасановНияз Рустемович
Russian Federation

MD, Dr. Sci. (Med.), Prof., Head of Depart., Depart. of Propaedeutic of Internal Diseases named after Prof. S.S. Zimnitsky

д-р мед. наук, проф., зав. каф., каф. пропедевтики внутренних болезней им. проф. С.С. Зимницкого

ybzp@mail.ruKazan State Medical UniversityКазанский государственный медицинский университет2711202410568798862008202429102024Copyright ©; 2024, Eco-VectorCopyright ©; 2024, Эко-Вектор2024Eco-VectorЭко-Векторhttp://creativecommons.org/licenses/by-nc-sa/4.0https://kazanmedjournal.ru/kazanmedj/article/view/634980

BACKGROUND: Iron deficiency is associated with worse contractile function of the heart in patients after myocardial infarction.

AIM: To study the contractile function of the left ventricle in patients with myocardial infarction and iron deficiency for 12 months while taking iron supplements.

MATERIAL AND METHODS: The study included 83 patients with myocardial infarction and iron deficiency. The average age was 62.0±11 years. The patients underwent drug correction of iron deficiency by parenteral administration of iron carboxymaltose or oral administration of iron sulfate. After 3 months, the patients were divided into two groups depending on the compensation of iron deficiency. The first group consisted of 58 (70%) patients with compensated iron deficiency, the second group — 25 (30%) patients with persistent deficiency. The patients underwent echocardiography with assessment of the left ventricular ejection fraction and the total index of its myocardial mobility in the first 24 hours after hospitalization, after 3, 6 and 12 months. Comparison of mean values was performed using the Mann–Whitney U-test. Differences in indicators were considered statistically significant at p <0.05.

RESULTS: In the first 24 hours after hospitalization for myocardial infarction, the ejection fraction did not differ in patients: in the first group — 48% [45; 54], in the second — 53% [48; 54] (p=0.07). In the first group, an increase in the ejection fraction was found compared to the baseline value: 53% [46; 58] (p <0.001) 6 months after myocardial infarction, 55% [48; 58] (p <0.001) after 12 months. In the second group, the ejection fraction after 3, 6 and 12 months did not differ from the baseline. The total myocardial mobility index on the 1st day after myocardial infarction did not differ between the groups: 1.25 [1.19; 1.62] in the first group and 1.25 [1.12; 1.56] in the second group (p=0.3). Its decrease was found in the first group: 1.19 [1.06; 1.56] (p <0.001) after 6 months and 1.12 [1.0; 1.44] (p <0.001) after 12 months. In the second group, the values of the total myocardial mobility index after 3, 6 and 12 months did not differ from the initial ones.

CONCLUSION: Iron deficiency compensation is associated with improved left ventricular systolic function within 12 months after myocardial infarction.

Актуальность. Дефицит железа ассоциирован с худшими показателями сократительной функции сердца у пациентов, перенёсших инфаркт миокарда.

Цель. Изучить сократительную функцию левого желудочка у пациентов с инфарктом миокарда и дефицитом железа в течение 12 мес на фоне применения препаратов железа.

Материал и методы. В исследование включены 83 пациента с инфарктом миокарда и дефицитом железа. Средний возраст составил 62,0±11 лет. Пациентам проводили медикаментозную коррекцию дефицита железа путём парентерального введения карбоксимальтозата железа или перорального приема железа сульфата. Через 3 мес пациенты были разделены на две группы в зависимости от компенсации дефицита железа. Первую группу составили 58 (70%) пациентов с компенсированным дефицитом железа, вторую группу — 25 (30%) пациентов с сохраняющимся дефицитом. Пациентам проведена эхокардиография с оценкой фракции выброса и индекса суммарной подвижности миокарда левого желудочка в первые 24 ч после госпитализации, через 3, 6 и 12 мес. Сравнение средних величин выполнено с использованием U-критерия Манна–Уитни. Различия показателей считали статистически значимыми при p <0,05.

Результаты. В первые 24 ч после госпитализации по поводу инфаркта миокарда фракция выброса у пациентов не различалась: в первой группе — 48% [45; 54], во второй — 53% [48; 54] (р=0,07). В первой группе обнаружено увеличение фракции выброса по сравнению с исходным значением: 53% [46; 58] (р <0,001) через 6 мес после инфаркта миокарда, 55% [48; 58] (р <0,001) через 12 мес. Во второй группе фракция выброса через 3, 6 и 12 мес не отличалась от исходной. Суммарный индекс подвижности миокарда в 1-е сутки после инфаркта миокарда не различался между группами: 1,25 [1,19; 1,62] в первой группе и 1,25 [1,12; 1,56] во второй группе (р=0,3). Было обнаружено его снижение в первой группе: 1,19 [1,06; 1,56] (р <0,001) через 6 мес и 1,12 [1,0; 1,44] (р <0,001) через 12 мес. Во второй группе значения суммарного индекса подвижности миокарда через 3, 6 и 12 мес не отличались от исходных.

Вывод. Компенсация дефицита железа ассоциирована с улучшением систолической функцией левого желудочка в течение 12 мес после инфаркта миокарда.

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