Changes in Cardiac Function and Exercise Capacity Following Ferric Carboxymaltose Administration in HFrEF Patients...

Area of Science:

• Cardiology
• Cardiovascular Medicine
• Clinical Research

Background:

• Iron deficiency (ID) is a frequent and significant comorbidity in heart failure with reduced ejection fraction (HFrEF).
• ID negatively impacts functional status, exercise capacity, and survival in HFrEF patients.
• The effects of intravenous ferric carboxymaltose (FCM) on cardiac structure and function in HFrEF with ID require further elucidation.

Purpose of the Study:

• To evaluate the impact of intravenous FCM on echocardiographic indices of left ventricular (LV), left atrial (LA), and right ventricular (RV) morphology and function in HFrEF patients with ID.
• To determine the correlation between echocardiographic changes and improvements in exercise capacity following FCM treatment.

Main Methods:

• A sub-analysis of the RESAFE-HF registry included 86 HFrEF patients with ID.
• Transthoracic echocardiography was performed at baseline and 12 months post-FCM administration.
• Key parameters assessed included LV ejection fraction (LVEF), LV global longitudinal strain (GLS), LV diastolic function, LA volume index (LAVi), LA strain, TAPSE, and RV free wall strain (FWS). Peak oxygen consumption (Peak VO2) was measured.

Main Results:

• FCM treatment led to significant improvements in LVEF, LV GLS, LV diastolic function grade, LAVi, LA strain, TAPSE, and RV FWS.
• Peak VO2 increased significantly post-FCM therapy.
• Improvements in LVEF, RV FWS, and LV GLS were independent predictors of VO2 increase, explaining 42% of the variance.

Conclusions:

• Intravenous ferric carboxymaltose therapy enhances biventricular and atrial function in HFrEF patients with ID.
• Observed echocardiographic improvements are significantly correlated with enhanced exercise capacity.
• FCM is a viable therapeutic option for improving cardiac function and exercise tolerance in this patient population.