A Study of Left Ventricular Dysfunction in Patients with Severe Iron Deficiency in a Tertiary Care Hospital, Nandyal

Abstract

Background: Anaemia is one of the major public health\nproblems worldwide. Commonest nutritional deficiency\naffecting more than 1.2 billion individuals worldwide 1. Iron\ndeficiency anaemia is associated with a reduction in physical\nwell being and decreased exercise capacity. The prevalence of\nanaemia is 30% in stable heart failure and 50% in hospitalized\nheart failure patients, compared with less than 10% in the\ngeneral population 2.In iron deficiency anaemia, to maintain\nadequate oxygen delivery, cardiac output can increase by the\ncompensatory increase in blood volume, preload, heart rate,\nand stroke volume, and decrease in afterload.If severe iron\ndeficiency anaemia left untreated, it could cause secondary\norgan damage. Chronic severe iron deficiency anaemia causes\ncardiac remodelling, cardiomegaly, arrhythmia, left ventricular\nhypertrophy, and heart failure.\nAim: To study the left ventricular dysfunction in patients with\nsevere iron deficiency admitted in a tertiary care hospital.\nMaterials and Methods: A Hospital-based Prospective study\nwas conducted in the Department of Medicine, Santhiram\nmedical college & general hospital for a 2 year period. Universal\nSampling Technique was used for the selection of study\nsubjects. All the patients coming to the medicine department\nduring the study period with age > 18years with informed\nwritten consent taken from the patient,Hemoglobin< 6gm/dl\n(according to WHO criteria) and Red cell indices suggestive of\niron deficiency anaemia The final sample size was 100 subjects.\nResults: Out of 100 patients, 62% were females, and 38% were\nmales in the study group. The mean age in the study population\nwas 40.68±12.5 years, with the minimum age being 18 years\nand maximum age is 70 years. The prevalence of LV dysfunction\nin the study group was 61%.51% of the total population had\nsystolic dysfunction and 10% had diastolic dysfunction.39% of\nthe total population had normal LV function. In patients with\nsystolic dysfunction, 72.5% were females, and 27.5% were\nmales. In diastolic dysfunction, 50% were males, and 50% were\nfemales.\nConclusion: As iron deficiency anaemia is more prevalent\nglobally, its consequences on the cardiovascular system were\nstudied. Iron deficiency anaemia is a major public health\nproblem in developing countries, and it causes major\ncardiovascular morbidity and mortality. Severe iron deficiency\nanaemia causes structural changes in the left ventricle leading\nto eccentric or concentric hypertrophy, which predisposes the\npatients to develop left ventricular dysfunction. Hence, early\ndiagnosis and management of iron deficiency anaemia can\nreverse remodelling and prevent left ventricular dysfunction.\nThus, reducing major cardiovascular morbidity and mortality.