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Iron deficiency in heart failure

Elisabetta Dinatolo1, Nicolò Dasseni1, Marco Metra1

  • 1Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.

Journal of Cardiovascular Medicine (Hagerstown, Md.)
|September 18, 2018
PubMed

Insights

Iron deficiency is common in heart failure patients and worsens quality of life and outcomes. Intravenous iron supplementation improves symptoms and exercise capacity, reducing hospitalizations.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Clinical Research

Background:

  • Iron deficiency is a prevalent comorbidity in heart failure (HF) patients, affecting up to 50%.
  • It is independently associated with reduced quality of life, exercise tolerance, and increased mortality.
  • Aging populations exacerbate the challenge of managing comorbidities like iron deficiency in HF.

Purpose of the Study:

  • To review the impact of iron deficiency in heart failure patients.
  • To evaluate the efficacy of intravenous iron supplementation as a therapeutic target.
  • To align with current European Society of Cardiology (ESC) guidelines for HF management.

Main Methods:

  • Review of randomized controlled trials (RCTs) and meta-analyses.
  • Analysis of data on quality of life, exercise capacity (VO2 peak, 6MWT), and hospitalization rates.
  • Examination of diagnostic criteria for iron deficiency (ferritin and TSAT levels).

Main Results:

  • Intravenous iron supplementation significantly improves symptoms and quality of life in HF patients with iron deficiency.
  • Enhanced exercise tolerance, measured by VO2 peak and 6MWT, is a key benefit.
  • A trend towards reduced hospitalization rates was observed with iron treatment.

Conclusions:

  • Iron deficiency is a critical, treatable comorbidity in heart failure patients.
  • Intravenous iron, particularly ferric carboxymaltose, is recommended for symptomatic patients based on defined iron deficiency criteria.
  • Ongoing research aims to further optimize the treatment of iron deficiency in HF.

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