Iron Status and Short-Term Recovery after Non-Severe Acute Myocarditis: A Prospective Observational Study

Area of Science:

• Cardiology
• Hematology
• Pathophysiology

Background:

• Myocarditis (MCD) recovery and progression to cardiomyopathy mechanisms are unclear.
• Iron impacts inflammation and cardiomyocyte energy metabolism, potentially influencing inflammatory myocardial disease.
• Systemic iron parameters' role in MCD pathophysiology requires investigation.

Purpose of the Study:

• To assess the relationship between systemic iron parameters and myocardial dysfunction in acute myocarditis patients.
• To evaluate iron status changes during hospitalization and post-discharge follow-up.
• To correlate iron status with clinical, laboratory, and echocardiographic indices.

Main Methods:

• Prospective enrollment of 42 hospitalized MCD patients and healthy controls.
• Assessment of iron status (serum ferritin, hepcidin, iron, TSAT) during hospitalization and 6 weeks post-discharge.
• Evaluation of clinical, laboratory (NT-proBNP), and echocardiographic (LVEF, GLS) indices.

Main Results:

• MCD patients exhibited higher serum ferritin/hepcidin and lower serum iron/TSAT than controls (p < 0.01).
• Iron status normalized by 6 weeks post-discharge.
• Lower in-hospital serum iron and TSAT correlated with higher NT-proBNP (p < 0.05) and persistent lower LVEF and worse GLS (p < 0.05).

Conclusions:

• Acute MCD alters iron status, which recovers within six weeks.
• Low serum iron and TSAT in acute MCD are linked to increased in-hospital neurohormonal activation.
• These iron derangements correlate with subtle, persistent left ventricular dysfunction post-myocarditis.