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Chronic Heart Failure: Clinical Implications of Iron Homeostasis Disturbances Revisited

Leonardo P Suciadi1, Joshua Henrina2, Iwan Cahyo Santosa Putra3

  • 1Cardiology, Siloam Hospitals Kebon Jeruk/Siloam Heart Institute, Jakarta, IDN.

Cureus
|February 18, 2022
PubMed

Insights

Iron deficiency is common in chronic heart failure (CHF). Prompt diagnosis and intravenous iron therapy improve symptoms, function, and quality of life in these patients.

Area of Science:

  • Cardiology
  • Hematology
  • Internal Medicine

Background:

  • Iron deficiency is highly prevalent in patients with chronic heart failure (CHF).
  • Diagnosis is often delayed, with treatment initiated only after anemia becomes apparent.
  • Clinical practice guidelines emphasize the need for proper management of iron deficiency in CHF.

Purpose of the Study:

  • To review iron homeostasis and its pathophysiologic changes in CHF.
  • To discuss the clinical implications of iron deficiency in CHF patients.
  • To outline the progression of clinical trials for iron deficiency treatment in CHF.

Main Methods:

  • Comprehensive literature review of iron homeostasis, pathophysiology, and clinical trials.
  • Analysis of studies on iron supplementation in heart failure patients.
  • Examination of current clinical practice guidelines.

Main Results:

  • Iron deficiency significantly worsens clinical outcomes in CHF patients.
  • Iron supplementation, especially intravenous, improves symptoms, functional capacity, and quality of life.
  • Routine screening for iron status is recommended for all newly diagnosed heart failure patients.

Conclusions:

  • Current guidelines recommend screening all heart failure patients for iron deficiency.
  • Intravenous iron replacement is advised for symptomatic heart failure patients with iron deficiency, even without anemia.

Keywords:
chronic heart failureintravenousiron deficiencyiron therapyoral

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