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 problems worldwide. Commonest nutritional deficiency affecting more than 1.2 billion individuals worldwide 1. Iron deficiency anaemia is associated with a reduction in physical well being and decreased exercise capacity. The prevalence of anaemia is 30% in stable heart failure and 50% in hospitalized heart failure patients, compared with less than 10% in the general population 2.In iron deficiency anaemia, to maintain adequate oxygen delivery, cardiac output can increase by the compensatory increase in blood volume, preload, heart rate, and stroke volume, and decrease in afterload.If severe iron deficiency anaemia left untreated, it could cause secondary organ damage. Chronic severe iron deficiency anaemia causes cardiac remodelling, cardiomegaly, arrhythmia, left ventricular hypertrophy, and heart failure. Aim: To study the left ventricular dysfunction in patients with severe iron deficiency admitted in a tertiary care hospital. Materials and Methods: A Hospital-based Prospective study was conducted in the Department of Medicine, Santhiram medical college & general hospital for a 2 year period. Universal Sampling Technique was used for the selection of study subjects. All the patients coming to the medicine department during the study period with age > 18years with informed written consent taken from the patient,Hemoglobin< 6gm/dl (according to WHO criteria) and Red cell indices suggestive of iron deficiency anaemia The final sample size was 100 subjects. Results: Out of 100 patients, 62% were females, and 38% were males in the study group. The mean age in the study population was 40.68±12.5 years, with the minimum age being 18 years and maximum age is 70 years. The prevalence of LV dysfunction in the study group was 61%.51% of the total population had systolic dysfunction and 10% had diastolic dysfunction.39% of the total population had normal LV function. In patients with systolic dysfunction, 72.5% were females, and 27.5% were males. In diastolic dysfunction, 50% were males, and 50% were females. Conclusion: As iron deficiency anaemia is more prevalent globally, its consequences on the cardiovascular system were studied. Iron deficiency anaemia is a major public health problem in developing countries, and it causes major cardiovascular morbidity and mortality. Severe iron deficiency anaemia causes structural changes in the left ventricle leading to eccentric or concentric hypertrophy, which predisposes the patients to develop left ventricular dysfunction. Hence, early diagnosis and management of iron deficiency anaemia can reverse remodelling and prevent left ventricular dysfunction. Thus, reducing major cardiovascular morbidity and mortality.