Cardiac links, abstracts, articles, etc.
Click on the title to read more about iron & the heart.
Cardiac alterations in 36 consecutive patients with idiopathic haemochromatosis: polygraphic and echocardiographic evaluation. Eur Heart J 1991 Feb;12(2):224-30 Early diagnosis and treatment of IH cardiopathy is needed before irreversible cardiac damage occurs
Cardiac dysfunction because of secondary hemochromatosis caused by congenital non-spherocytic hemolytic anemia. Jpn Circ J. 2001 Feb Cardiac failure accounts for approximately one-third of the deaths associated with hemochromatosis. Liver dysfunction or hormonal disorders such as diabetes generally precede cardiac failure
hemochromatosis: beneficial effects of iron removal therapy. An echocardiographic study.
Statistically significant increases in left ventricular (LV) mass, end-diastolic and end-systolic diameters of the left ventricle and in left atrial dimension were observed in patients with IH; significant changes of systolic function indexes (decrease in fractional shortening and ejection fraction and increase in distance of the E point to the septum) were seen as well. Am J Cardiol 1983 Oct 1
Cardiac pathology of extracardiac origin (II). The cardiac repercussion of amyloidosis and hemochromatosis Rev Esp Cardiol 1997 Nov. Although rare, amyloidosis and hemochromatosis are the infiltrative diseases in which the heart is more frequently involved. The most common clinical presentation is heart failure with hemodynamic features of restrictive heart disease in cardiac amyloidosis. [Abstract in English, Article in Spanish]
Cardiomyopathy Data Highway Report of the 1995 WHO/ISFC Task Force on the Definition and Classification of Cardiomyopathies, Circulation 1996
Chronic iron overload and toxicity: clinical chemistry perspective. Clin Lab Sci 2001 Summer; This toxicity involves many organs leading to a variety of serious diseases such as liver disease, heart disease, diabetes mellitus, hormonal abnormalities, dysfunctional immune system, etc. The tissue damage associated with iron overload is believed to result primarily from free radical reactions mediated by iron.
Clinical and molecular aspects of juvenile hemochromatosis in Saguenay-Lac-Saint-Jean (Quebec, canada)Blood Cells Mol Dis 2000 Feb Although the mean age at onset of the first symptoms was 21. 5 years, their mean age at diagnosis was 23.8 years; the diagnosis was particularly delayed among women. Seventy-seven percent of the patients had hypogonadotrophic hypogonadism and 69% heart failure and/or cardiac arrhythmias.
Clinical Consequences of New Insights in the Pathophysiology of Disorders of Iron and Heme Metabolism Hematology 2000 The American Society of Hematology The screening strategy could be based on the assessment of serum transferrin saturation in adults aged 18 or more. Genetic testing testing for C282Y would be confined to individuals with transferrin saturation > 45%. This strategy would then avoid the ethical, logistical, and financial problems raised by systematic genetic testing as well as the societal impact of discovering a genetic mutation in asymptomatic persons without a disease. It is, in fact, essential that major changes occur in the attitudes towards unexpressed or slightly expressed HFE homozygosity, especially by insurers and health care administrators, to avoid any adverse genetic discrimination.
Clinical management of iron overload. Gastroenterol Clin North Am. 1998 Sep HHC is a common inherited disorder, characterized by iron accumulation in the liver, heart, pancreas, and other organs. The clinical consequences of systemic iron loading are diverse and not always improved with iron reduction therapy.
Clinical spectrum and management of
Baillieres Clin Haematol 1994 Dec Further strategies have to evaluate the design of screening programmes in order to diagnose more patients in the precirrhotic and asymptomatic stage.
Clinical Studies of Haemochromatosis Queensland Institute of Medical Research, Hepatocellular Cancer Laboratory, Professor Lawrie Powell Knowledge of haemochromatosis, its prevention, the type and severity of symptoms it causes, the availability and nature of treatment, ability of sufferers to participate in normal activities, and longevity are relevant issues for community education. Members of an informed public can mobilise support for the early diagnosis of haemochromatosis, encourage people to be tested for the disorder and influence the debate about screening.
Clinico-morphologic characteristics of primary hemochromatosis
Arkh Patol. 1995 Nov-Dec 12 autopsy cases of primary hemochromatosis were studied
Combined orthotopic heart and liver transplantation for genetic
J Heart Lung Transplant. 1997 May Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, 55905, USA. A 47-year-old man with cirrhotic liver disease complicated by encephalopathy and class IV congestive heart failure caused by genetic hemochromatosis underwent combined orthotopic heart and liver transplantation. The patient remains well, working full time, 4 years after operation. Combined heart and liver transplantation is an effective therapy for selected patients with concurrent heart and liver failure caused by systemic iron overload.
Correlation between the depth of inverted T waves and the serum level of ferritin in a deferoxamine-treated patient with primary hemochromatosis and hyperthyroidism. Jpn J Med. 1989 Mar-Apr There seemed to be a correlation between the depth of inverted T waves and the serum level of ferritin.
Current concepts in rational therapy for haemochromatosis.
Drugs. 1991 Jun . Venesection should be continued until all excess iron stores are removed as judged by failure of a rise in haemoglobin concentration on cessation of phlebotomy. Screening of first degree relatives should commence from a young age (e.g. 10 years).
diagnosis: hereditary metabolic diseases of the liver
(primary hemochromatosis, Wilson disease] Schweiz Rundsch Med Prax 1996 Nov [article in German]
and Management of Decompensated Congestive Heart Failure
Library of National Medical Society, Non-Ischemic Causes of CHF include Iron (Hemochromatosis)
Diagnosis and management of hemochromatosis by Dr. Anthony Tavill, Director of the Maurice and Sadie Friedman Center For Digestive Diseases and Liver Disorders, Mathile and Morton J. Stone Professor of Digestive Diseases and Liver Disorders at the Mt. Sinai Medical Center, Professor of Medicine and Nutrition at Case Wetern Reserve University. [Excellent & thorough article of diagnosis & treatment. This is a pdf file]
Diagnosis and treatment of genetic hemochromatosis
Rev Prat. 2000 May 1 [Article in
Moirand R, Guillygomarc'h A, Brissot P, Deugnier Y. The disease can be lethal due to liver disease, carcinoma or heart disease, but life expectancy goes to normal if patients are treated before the occurrence of cirrhosis. Treatment relies on regular venesections. Familial screening is essential.
Dietary Iron Supplements - Use or not to use? Nutrition Today James R. Connor John L. Beard 05-06-1997 There is little reason to support a general need for iron supplementation in the diet at any age. Perhaps this article and review of supplementation pros and cons should conclude with a new interpretation of an old saying: "It is better to wear out than to rust out;" don't expose your system to more iron than it needs.
Conditions in Relatives of Patients with Hemochromatosis
Zaneta J. Bulaj, M.D., Richard S. Ajioka, Ph.D., John D. Phillips, Ph.D., Bernard A. LaSalle, B.S., Lynn B. Jorde, Ph.D., Linda M. Griffen, B.A., Corwin Q. Edwards, M.D., and James P. Kushner, M.D. Volume 343:1529-1535 November 23, 2000 Number 21 In conclusion, our data emphasize the importance of screening relatives of persons with hemochromatosis.
Echocardiographic features of idiopathic hemochromatosis. In conclusion, there is a spectrum of cardiac dysfunction in idiopathic hemochromatosis. Am J Cardiol 1987 Oct
biopsy in hemochromatosis: clinicopathologic correlates in six cases
Iron staining is recommended for endomyocardial biopsy specimens from patients with idiopathic cardiac dysfunction. J Am Coll Cardiol 1989 Jan
Editor: George R Bowers MD CDH Oncology January 2000 Volume 4: No. 1. Hemochromatosis is a common, genetically transmitted disease. The diagnosis of hemochromatosis is sometimes difficult and frequently missed. This issue will review the pathogenesis, diagnosis and treatment of this fascinating disease. Ms. Kathy Fleming will review the management of a most troubling complication of therapy---lymphedema.
hereditary hemochromatotic cardiomyopathy
responsive to small-volume venesections combined with deferoxamine, case reports
pregnancy following gonadotropin therapy in a young female with juvenile
idiopathic hemochromatosis and secondary hypogonadotropic hypogonadism
Haematologica 1995 Jul-Aug; Heart failure and hypogonadotropic hypogonadism are the most frequent clinical problems encountered in patients with juvenile idiopathic hemochromatosis
The Heart In Iron Overload September/October, 1995: Cardiovascular Medicine, case presentation
The HFE CYS282Tyr
polymorphism is associated with cardiovascular mortality.
Roest M, Schouw Yvd, B. de Valk BD, Marx JJM, Tempelman M, de Groot P, Sixma J, Banga JD. Presented at the July 1998 meeting of the European Iron Club. Conclusions: Heterozygosity for HH is associated with increased risk of cerebrovascular and total cardiovascular mortality, in particular in combination with hypertension and smoking. Long term exposure to minimal iron overload may enhance atherosclerosis.
morphological changes in the internal organs in hemochromatosis
Cardiomyopathy and diabetes mellitus at autopsy
The relationship between iron overload, clinical symptoms, and age in 410 patients with genetic hemochromatosis. Hepatology. 1997 Jan The nonspecific nature of the presenting features in patients and the presence of significant clinical symptoms in patients discovered through family investigations underscore the importance of family and population screening for hemochromatosis. The prevalence of cirrhosis, diabetes, cardiac disease, pigmentation, and fatigue increased as liver iron concentration increased. The most common presentations at diagnosis were fatigue
fit for a heart attack?
Well known marathon runner and author Jim Fixx had just had a checkup. His values were normal, including cholesterol, so the doctor declared him fit. Two days later he died of a heart attack.
much iron can hurt joints, body organs
The Albuquerque Tribune. By John Crowe The Associated Press 1/11/00
Much Iron May Lead to Heart Attack
Study Finds It Damages Vessel Lining By Jeff Levine WebMD Washington Bureau Chief Oct. 25, 2000
Use of HFE Mutation Analysis for Hereditary Hemochromatosis: The Need for Physician Education in the Translation of Basic Science to Clinical PracticeManish Kohli, MB, ChB, Steven A. Schichman, MD, PhD, Louis Fink, MD, Clive S. Zent, MB, BCh, Department of Internal Medicine, Division of Hematology/Oncology and the Department of Pathology, John L. McClellan Memorial Veteran's Hospital and University of Arkansas for Medical Sciences, Little Rock. Southern Medical Journal
Ventricular tachycardia and cardiac hemochromatosis Rev Esp Cardiol 2001 Nov
What's new in hemochromatosis. Curr Opin Hematol 2001 Mar The high correlation of HFE to HHC has caused it to be considered as a candidate gene for population-based genetic testing for diagnosis and detection of predisposition to HHC.
Why concentration of serum ferritin does not in all circumstances reflect storage iron but is still of value in its estimation. Rajantie J, Siimes MA. We describe a 10-year-old girl with familial haemochromatosis which is associated with a normal concentration of S-ferritin, myocardial disease and diabetes mellitus. We speculate that iron is accumulated primarily in the heart and pancreas as such isoferritins are not detected by the routine assay of serum ferritin based on antispleen or placenta ferritin.
Click on this link to read about HH. Discussion of a liver biopsy is also here:
Back to the "Munnsters" main Hemochromatosis page