Impact of anemia and iron deficiency on physical performance and quality of life in young and middle-aged patients with atrial fibrillation

Background. The clinical significance of anemia and iron deficiency (ID) in patients with atrial fibrillation (AF) is currently undetermined and requires further investigation. Objective. Analysis of the effect of anemia/ID on physical performance and quality of life in young and middle-aged patients with AF. Materials and methods. This cross-sectional, comparative study included 45 patients with AF (84.4 % male), who were divided into two groups: those with anemia and/or ID (n=23) and those without these conditions (n=22). Physical performance was assessed using a treadmill test and the six-minute walk test, while quality of life was evaluated using the SF-36 questionnaire. Results. Patients with AF and anemia/ID demonstrated lower peak exercise capacity compared to those without these conditions (4.8 [3.2; 5.5] vs. 7.0 [6.2; 9.2] METs, p<0.001); a higher proportion of patients without anemia/ID reached submaximal heart rate compared to those with anemia/ID (59 % and 22 %, respectively, p=0.028). A greater number of patients in the anemia/ID group exhibited low exercise tolerance compared to the nonanemic/non-ID group (70 % and 27 %, respectively, p=0.006). In the six-minute walk test, patients with anemia/ID covered a shorter distance than those without anemia/ID (765 [697.5; 837.5] vs. 905 [857; 995] meters, p<0.001). In patients with AF and anemia/ID, the final score for the Physical Component Summary (PCS) of health was statistically significantly lower compared to the group without anemia/ID (45.5 [39.7; 49.8] vs. 55 [45; 58] points, p=0.007). A similar result was observed when assessing the Mental Component Summary (MCS) of health (38 [33.5; 44.5] vs. 45 [40.8; 49] points, p=0.024). Conclusions. In young and middle-aged patients with AF, the presence of anemia and/or ID leads to decreased physical performance and reduced quality of life.