Objective:

The aim of this study was to assess the prevalence of iron deficiency in pulmonary hypertension, to compare it with other patient populations and to establish its prognostic value.

Methods:

This was a prospective, observational study. Serum iron parameters were measured in consecutive patients diagnosed with pulmonary hypertension and compared with heart failure patients and healthy controls. A correlation was sought between serum iron levels and functional class, distance walked in the 6-minute walk test and NT-proBNP.

Results:

A total of 107 patients were included in the study: 60 with pulmonary hypertension, 26 with heart failure and 21 healthy controls. Iron deficiency was 78.3% in patients with pulmonary hypertension, 45.8% in those with heart failure and 23.8% in healthy controls (p<0.001). The prevalence of anemia was 25% in pulmonary hypertension, 26.9% in heart failure and 19% in healthy controls (p<0.8). In patients with functional class I-II, iron deficiency was: 78% in pulmonary hypertension vs. 43.5% in heart failure (p<0.005), and anemia was 17.1% vs. 28%, respectively (p<0.2). A significant correlation was found between serum iron and transferrin saturation with the distance walked in the 6-minute walk test (r: 0.35; p<0.01 and r: 0.34; p<0.01, respectively) and no correlation was found for transferrin and ferritin. Also, no significant correlation was found between iron deficiency and functional class or NT-proBNP.

Conclusions:

Iron deficiency is highly prevalent in pulmonary hypertension, and superior to that found in heart failure patients and healthy controls. No relationship was established with anemia, which was similar in the three groups. Serum iron is clearly related with the distance walked, but not with functional class, a result which may be attributed to the limited number of patients.

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