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Myocardial iron homeostasis in advanced chronic heart failure patients

Przemysław Leszek1, Barbara Sochanowicz, Małgorzata Szperl

  • 1Institute of Cardiology, ul. Alpejska 42, 04-628 Warszawa, Poland. przemyslaw.leszek@ikard.pl

International Journal of Cardiology
|September 9, 2011
PubMed

Insights

Heart failure patients show reduced myocardial iron levels, which are not accurately reflected by standard serum iron markers, except for soluble transferrin receptor (sTfR). Myocardial ferritin decreased in patients with low serum iron.

Area of Science:

  • Cardiology
  • Biochemistry
  • Iron Metabolism

Background:

  • Iron deficiency and anemia are common in heart failure (HF).
  • Current iron supplementation guidelines rely on serum iron markers.
  • Myocardial iron load and homeostasis in HF remain poorly understood.

Purpose of the Study:

  • To assess myocardial iron (M-Iron), ferritin (M-FR), and transferrin receptor (M-sTfR) in HF patients.
  • To compare myocardial iron markers with serum iron markers.
  • To investigate the relationship between myocardial iron status and serum iron levels.

Main Methods:

  • Analysis of explanted failing hearts (FH) from 33 HF patients and 11 non-failing hearts (NFH).
  • Measurement of myocardial iron using Instrumental Neutron Activation Analysis (INAA).
  • Quantification of myocardial ferritin and transferrin receptor using ELISA.
  • Assessment of serum iron, ferritin, transferrin saturation (TSAT), and soluble transferrin receptor (sTfR).

Main Results:

  • Myocardial iron (M-Iron) was significantly reduced in both left (LV) and right ventricles (RV) of FH compared to NFH.
  • Serum soluble transferrin receptor (sTfR) was the only serum marker negatively correlated with M-Iron.
  • In patients with reduced serum iron (TSAT < 15%), myocardial ferritin (M-FR) was significantly lower in the RV compared to those with normal serum iron.

Conclusions:

  • Myocardial iron levels are reduced in heart failure patients.
  • Serum iron markers, except for sTfR, do not reliably reflect myocardial iron levels.
  • Reduced serum iron is associated with decreased myocardial ferritin storage in HF.
Abstract

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