Chronic heart failure with reduced and mildly reduced left ventricle ejection fraction: relationship between mitochondrial respiratory dysfunction of peripheral blood mononuclear cells and iron deficiency

慢性心力衰竭伴左心室射血分数降低或轻度降低:外周血单核细胞线粒体呼吸功能障碍与铁缺乏的关系

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Abstract

OBJECTIVES: To compare respiratory parameters of peripheral blood mononuclear cell mitochondria and iron metabolism indicators in patients with different NYHA functional classes of ischemic heart failure (HF). METHODS: This single center, prospective, non-blinded study enrolled 20 patients with diagnosed chronic HF of ischemic genesis with reduced and mildly reduced left ventricle ejection fraction. The maximum oxygen consumption at the peak of the exercise test (VO(2) peak), iron metabolism parameters and respiratory activity of peripheral blood mononuclear cell mitochondria were assessed. RESULTS: Among the patients, a half of individuals were diagnosed with iron deficiency. Subgroups of patients with different HF severity did not significant differ in VO(2) peak (P = 0.209), serum iron (P = 0.468) and ferritin (P = 0.235) levels. But there was a trend in increasing in these parameters with increasing NYHA HF functional class. Respiratory control coefficient (RC) in NAD-dependent and FAD-dependent mitochondrial oxidation were lower in patients with NYHA HF III functional class compared to individuals with NYHA HF I functional class (P = 0.028 and P = 0.040, respectively). Serum iron (P = 0.026), ferritin (P = 0.045) levels, transferrin saturation (P = 0.006) were negatively correlated with RC in NAD-dependent mitochondrial oxidation. CONCLUSIONS: In aggravation of ischemic HF NYHA FC, there is a decrease in RC of PBMC mitochondria during the oxidation of NAD-dependent and FAD-dependent substrates. In the whole sample, patients with laboratory-confirmed iron deficiency accounted a half of the total number. Iron metabolism parameters had a paradoxical inverse relationship with the level of RC in PBMC mitochondria of patients with HF.

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