Iron deficiency and nutritional status in heart failure with reduced ejection fraction: a cross-sectional study

Iron deficiency (ID) impacts prognosis and quality of life for heart failure (HF) patients. It is essential to actively search for ID in this group and establish its relationship with nutritional status. The aim was to determine the relationship between nutritional status according to the Mini Nutritional Assessment (MNA) questionnaire and the presence of ID in heart failure patients with reduced ejection fraction (HFrEF).

The study sample comprized 272 HFrEF patients. Collected on admission were: medical history, echocardiographic and biochemical parameters. Iron deficiency was diagnosed if ferritin was < 100 ng/mL or < 300 ng/mL with transferrin saturation (TSAT) < 20%. Nutritional status was assessed using the MNA form and body mass index (BMI).

The cohort was 81.6% male and 18.4% female. The median age was 59 (IQR 50-64) years, and the mean BMI was 28.8 ± 5.3 kg/m². 54.4% of patients showed New York Heart Association (NYHA) class III or IV HF symptoms. Iron deficiency was detected in 55.5% of patients. Participants at risk of malnutrition constituted 45.2%, while 1.8% were malnourished. In the ID group 45% were at risk of malnutrition and 2.6% were malnourished, compared with 45.4% (p = 1.00) and 0.8% (p = 0.39) in the no-ID group. Female sex and atrial fibrillation(AF) were associated with ID.

Nutritional status assessed by the MNA questionnaire is not related to the presence of ID in HFrEF. Female sex and AF are risk factors for ID in this group.