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Influence of mitochondrial and systemic iron levels in heart failure pathology
Mihai Lupu1, Diana-Valentina Tudor2, Gabriela Adriana Filip2
1Department of Physiology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 1 Clinicilor Str, 400006, Cluj-Napoca, Cluj, Romania. lupu.mihai@umfcluj.ro.
Insights
Iron deficiency and overload complicate heart failure. While iron supplementation may offer symptomatic relief, its potential negative effects on heart health require further investigation.
Area of Science:
- Cardiology
- Metabolic Disorders
- Biochemistry
Background:
- Cardiovascular disease, particularly heart failure, is increasingly associated with iron dysmetabolism.
- A significant proportion of heart failure patients experience decreased plasma iron levels, impacting quality of life.
Purpose of the Study:
- To review iron metabolism in the context of cardiovascular disease.
- To explore the rationale for iron supplementation and iron chelation therapies.
- To analyze the complex relationship between iron levels and heart failure.
Main Methods:
- Literature review of studies on iron metabolism, supplementation, and chelation in heart failure.
- Analysis of current guidelines and emerging evidence regarding iron's role in cardiovascular health.
- Examination of molecular targets and mechanisms of iron's effects on the heart.
Main Results:
- Iron supplementation shows potential benefits for symptomatic relief in heart failure patients.
- Emerging evidence suggests negative impacts of dysregulated non-bound iron and reactive oxygen species on heart disease.
- Mitochondria are identified as key cellular targets susceptible to iron-induced damage.
Conclusions:
- Iron supplementation and chelation present potential therapeutic avenues for heart failure, though mechanisms require further elucidation.
- Understanding the balance between systemic and mitochondrial iron levels is crucial for future advancements in heart failure treatment.
- Further research is needed to fully comprehend the intricate connection between iron metabolism and heart failure progression.
Abstract:
Iron deficiency or overload poses an increasingly complex issue in cardiovascular disease, especially heart failure. The potential benefits and side effects of iron supplementation are still a matter of concern, even though current guidelines suggest therapeutic management of iron deficiency. In this review, we sought to examine the iron metabolism and to identify the rationale behind iron supplementation and iron chelation. Cardiovascular disease is increasingly linked with iron dysmetabolism, with an increased proportion of heart failure patients being affected by decreased plasma iron levels and in turn, by the decreased quality of life. Multiple studies have concluded on a benefit of iron administration, even if just for symptomatic relief. However, new studies field evidence for negative effects of dysregulated non-bound iron and its reactive oxygen species production, with concern to heart diseases. The molecular targets of iron usage, such as the mitochondria, are prone to deleterious effects of the polyvalent metal, added by the scarcely described processes of iron elimination. Iron supplementation and iron chelation show promise of therapeutic benefit in heart failure, with the extent and mechanisms of both prospects not being entirely understood. It may be that a state of decreased systemic and increased mitochondrial iron levels proves to be a useful frame for future advancements in understanding the interconnection of heart failure and iron metabolism.
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