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Effect of Iron Supplementation on Pulmonary Hypertension Due to Lung Diseases FREE TO VIEW

Mitsuhiro Sumitani; Naomi Kagawa; Manabu Tsuda; Daiki Kobayashi; Masayoshi Nishijima; Seiichi Shoji
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Osaka City General Hospital, Osaka, Japan

Chest. 2014;146(4_MeetingAbstracts):854A. doi:10.1378/chest.1989520
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SESSION TITLE: Pulmonary Hypertension (Poster Discussion)

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: Our study is aimed to evaluation the short-term efficacy of Iron Supplementation on Pulmonary Hypertension due to Lung Diseases.

METHODS: In our open-label, single-arm and single center study, we enrolled lung disease patients with pulmonary hypertension. Eligible patients had to have haemoglobin is less than 16 mg/dl, ferritin is 500ng/ml or less, Tricuspid Regurgitation Pressure Gradient (TR-PG) by doppler echocardiography is more than 32 torr, and 60 years or older. The main outcome measure of efficacy was a change in TR-PG by Doppler Echocardiography. Secondary outcome measure of efficacy was a change in PaO2, NT-pro BNP, hematocrit (Ht), reticulocyte count, mean concentration hematocrit (MCH), and mean corpuscular hemoglobin concentration (MCHC). Participants received intravenous infusion of saccharated ferric oxide (120mg) and we evaluated the outcome 1 week later.

RESULTS: 10 participants enrolled in the study, and 1 participant withdrew consent before iron supplementation. 9 patients (male/female : 6/3 ; aged 64-80 years; WHO-FC: class 3, 9) completed the study. Lung diseases combined to pulmonary hypertension were 5 interstitial pneumonia, 2 COPD, and 2 bronchiectasis. Five of nine participants was improved by infusion of iron, which reduced TR-PG by 3.2 torr (-3.22 ± 4.6), from 49.2 torr (49.22 ± 4.5) to 46.0 torr (46.0 ± 4.4). As compared with the baseline, reticulocyte count had increased on eight participants, Ht had increased on six participants, MCH had increased on seven participants, MCHC had increased on four participants and NT-pro BNP had increased on three participants.

CONCLUSIONS: Pulmonary hypertension due to lung diseases may be attenuated by iron supplementation.

CLINICAL IMPLICATIONS: We may consider iron supplementation as optional one of treatment for pulmonary hypertension due to lung diseases.

DISCLOSURE: The following authors have nothing to disclose: Mitsuhiro Sumitani, Naomi Kagawa, Manabu Tsuda, Daiki Kobayashi, Masayoshi Nishijima, Seiichi Shoji

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