Influence of iron deficiency compensation on the maximal left atrium volume in heart failure patients with iron deficiency within 12 months after myocardial infarction
Authors:   Kazan State Medical University, Tarasova N. A. , Khastieva D. R. ,   Kazan State Medical University, Khasanov N. R. ,   Kazan State Medical University
Published: January 2025

According to available data, iron deficiency (ID) is a risk factor and predictor of adverse course and outcomes of cardiovascular diseases, in particular, heart failure. A smaller pool of data is accumulated in relation to coronary heart disease and myocardial infarction (MI). There are few works on the effect of iron deficiency in the patients with heart failure after myocardial infarction, hence, this topic requires further study.

The purpose — to study the changes in the maximal volume of left atrium in patients with heart failure and ID treated with iron supplements and normal iron status within 12 months after myocardial infarction.

Material and methods. The study included 106 patients (48 women (45.2%) and 58 men (54.7%)) hospitalized in Municipal Clinical Hospital No. 7 named after M.N. Sadykov with myocardial infarction in 2022–2023. The patients were divided into a group with iron deficiency — 59 (55.6%) patients, and a group without iron deficiency — 47 (44.4%) patients. The groups were comparable in terms of basic laboratory parameters, clinical and demographic characteristics, drug therapy, and prevalence of comorbidities. Atrial fibrillation was significantly more common in patients with baseline ID (11 patients, 18.6%) compared with the group without ID (2 patients, 4.25%), (p = 0.037); CHF was significantly more common in those without ID (2 patients, 3.4%) than in the group with ID (7 patients, 14.9%), (p = 0.040); inherited cardiovascular diseases were more common in patients without ID (8 patients, 13.5%) than in the group with ID (14 patients, 29.7%), (p = 0.030); smoking patients were significantly more common in the group with ID. The patients underwent iron deficiency correction. Depending on the correction, the patients were divided into 2 groups: group 1 with compensated iron deficiency (40 patients) and group 2 with non-compensated iron deficiency (19 patients). The groups were comparable in terms of basic clinical and demographic parameters, laboratory parameters, comorbidity, and drug therapy. Previous coronary artery bypass grafting (CABG), acute cerebral circulatory failure (ACBF), and MI were more frequently observed in patients with uncompensated ID. The patients underwent echocardiographic examination in the first 24 hours after hospitalization and 3, 6, 12 months later to assess the maximal volume of left atrium.

Results. Echo-CG showed a statistically significant increase in median left atrium volume after 3, 6 and 12 months compared with the initial volume in patients in the group with non-compensated ID (49.0 ml (45.5–60) initially; after 3 months — 51.0 (50–63) ml, after 6 months — 59.0 (52.0–63.0) ml, after 12 months — 59.0 (50–70) ml (р = 0.004). In the group with and without compensated ID, the left atrium volume did not change significantly (р = 0.055 and 0.289, respectively).

Conclusions. Non-compensated iron deficiency is associated with myocardial remodeling manifested in the increase of left atrium maximal volume.