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Published on: April 28, 2022
Increased iron absorption in patients with chronic heart failure and iron deficiency
Carin C Cabrera1, Mattias Ekström2, Cecilia Linde3
1Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden; Södersjukhuset, Department of Cardiology, Stockholm, Sweden.
Insights
Iron deficiency is common in chronic heart failure (CHF), but this study found iron absorption is increased, not decreased, in these patients. This suggests reduced absorption isn't the main cause of iron deficiency in CHF.
Area of Science:
- Cardiology
- Nutritional Science
- Hematology
Background:
- Iron deficiency (ID) is prevalent in patients with chronic heart failure (CHF).
- The specific causes of ID in CHF remain incompletely understood.
- This study investigated the role of iron absorption in ID among CHF patients.
Purpose of the Study:
- To determine if decreased iron absorption contributes to iron deficiency in patients with chronic heart failure.
- To compare iron absorption rates between patients with CHF and healthy controls.
Main Methods:
- An oral iron-absorption test using ferroglycin sulphate was conducted.
- Participants included 30 patients with CHF (reduced or preserved ejection fraction) and 12 healthy controls.
- Plasma iron levels were measured before and 2 hours after iron ingestion to assess absorption.
Main Results:
- Patients with CHF demonstrated significantly higher iron absorption compared to controls (P=0.001).
- The median increase in plasma iron was substantially greater in the CHF group.
- No significant difference in iron absorption was observed between CHF patients with reduced versus preserved ejection fraction.
Conclusions:
- Increased, not decreased, iron absorption was observed in patients with CHF and iron deficiency.
- Reduced iron absorption is unlikely to be the primary driver of iron deficiency in this population.
- Further research is needed to elucidate other causes of iron deficiency in chronic heart failure.
Background:
Iron deficiency (ID) is common in patients with chronic heart failure (CHF), but the underlying causes are not fully understood. We investigated whether ID is associated with decreased iron absorption in patients with CHF.
Methods And Results:
We performed an oral iron-absorption test in 30 patients and 12 controls. The patients had CHF with reduced (n = 15) or preserved (n = 15) ejection fraction and ID, defined as s-ferritin < 100 µg/L, or s-ferritin 100-299 µg/L and transferrin saturation < 20%. The controls had no HF or ID and were of similar age and gender. Blood samples were taken before and 2 hours after ingestion of 100 mg ferroglycin sulphate. The primary endpoint was the delta plasma iron at 2 hours. The delta plasma iron was higher in the group with HF than in the control group (median increase 83.8 [61.5;128.5] µg/dL in HF vs 47.5 [30.7;61.5] µg/dL in controls, P = 0.001), indicating increased iron absorption. There was no significant difference between the groups with preserved or reduced ejection fraction (P = 0.46).
Conclusion:
We found increased iron absorption in patients with CHF and ID compared to controls without ID and HF, indicating that reduced iron absorption is not a primary cause of the high prevalence of ID in patients with CHF.
Clinical Trial Registration:
EudraCT 2017-000158-21.
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