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Cardiac iron concentration in relation to systemic iron status and disease severity in non-ischaemic heart failure

Valentin G Hirsch1,2, Jörn Tongers2, Julia Bode3

  • 1Division of Molecular and Translational Cardiology, Hannover Medical School, Hannover, Germany.

European Journal of Heart Failure
|March 11, 2020
PubMed

Insights

Low cardiac iron levels are linked to worse heart failure in patients not yet advanced. This study measured cardiac iron concentration (CI) in non-advanced heart failure with reduced ejection fraction (HFrEF), finding it relates to disease severity.

Area of Science:

  • Cardiology
  • Biochemistry
  • Pathophysiology

Background:

  • Low cardiac iron is implicated in experimental heart failure models.
  • Cardiac iron concentration (CI) is reduced in advanced heart failure with reduced ejection fraction (HFrEF).
  • CI has not been previously assessed in non-advanced HFrEF.

Purpose of the Study:

  • To measure CI in patients with non-advanced HFrEF.
  • To investigate the association between CI and systemic iron status.
  • To explore the relationship between CI and heart failure disease severity.

Main Methods:

  • Eighty patients with non-ischaemic HFrEF (NYHA class II-III) underwent left ventricular endomyocardial biopsies (EMB).
  • Cardiac iron concentration (CI) was quantified in EMBs.
  • CI was analyzed for associations with systemic iron markers, anemia, and clinical disease severity indicators.

Main Results:

  • CI was not associated with immunohistological findings or viral genomes in EMBs.
  • CI did not correlate with systemic iron status or anemia biomarkers.
  • Patients with CI in the lowest quartile exhibited lower BMI, longer heart failure history, higher NT-proBNP, larger LV dimensions, and increased LV end-diastolic pressures.

Conclusions:

  • Lower CI is associated with greater disease severity in non-advanced, non-ischaemic HFrEF.
  • Cardiac iron concentration is independent of systemic iron homeostasis in this cohort.
  • Further research is warranted to determine the prognostic and therapeutic significance of CI measurements in EMBs.
Abstract

Keywords:
Endomyocardial biopsyInductively-coupled plasma optical emission spectroscopyIron deficiencyNon-ischaemic heart failure with reduced ejection fraction

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