Systemic iron deficiency does not affect the cardiac iron content and progression of heart failure

Area of Science:

• Cardiology
• Iron Metabolism
• Heart Failure Pathophysiology

Background:

• Chronic heart failure (HF) frequently co-occurs with systemic iron deficiency (ID).
• The impact of ID on cardiac iron status and HF progression remains unclear.

Purpose of the Study:

• To investigate the effects of systemic iron deficiency on cardiac iron content and heart failure progression in a rat model.
• To evaluate the functional consequences of iron deficiency on cardiomyocytes and left ventricular function.

Main Methods:

• Rats underwent LAD ligation to induce myocardial infarction-induced HF or sham operation.
• Animals were subjected to moderate or severe iron deficiency/anemia (IDA) for 5 weeks via phlebotomy and low-iron diet.
• Cardiac and serum iron content, iron handling protein expression, cardiomyocyte function, and left ventricular performance were assessed.

Main Results:

• Systemic ID and IDA reduced serum and hepatic iron but did not alter cardiac iron content in HF rats.
• Cardiomyocyte iron handling protein expression indicated preserved iron status.
• Iron deficiency augmented isolated left ventricular cardiomyocyte contractile function and calcium handling, accompanied by increased serum catecholamines.
• Left ventricular systolic and diastolic function remained unaffected by ID or IDA.

Conclusions:

• Systemic iron deficiency does not lead to cardiac iron deficiency or exacerbate HF progression.
• ID improves isolated cardiomyocyte function but elevates catecholamine levels.
• Intravenous iron therapy may be a beneficial adjunct in HF to mitigate adverse catecholaminergic effects.