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Association of Iron Deficiency With the Severity of Heart Failure With Preserved Ejection Fraction: A Hospital-Based

Dewan Mushfiq Raihan1, Mohammad Ullah2, Hashan Mamunur Rahman2

  • 1Cardiology, Shaheed Ziaur Rahman Medical College Hospital, Bogura, BGD.

Cureus
|August 24, 2026
PubMed

Insights

Iron deficiency is linked to worse heart failure with preserved ejection fraction (HFpEF) severity in Bangladeshi patients. This highlights the need for routine iron status checks in HFpEF management.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Clinical Research

Background:

  • Iron deficiency is a common issue in heart failure with preserved ejection fraction (HFpEF).
  • Local data on iron deficiency in HFpEF patients in Bangladesh is limited.
  • Understanding this association is crucial for patient management in the region.

Purpose of the Study:

  • To investigate the relationship between iron deficiency and the severity of HFpEF.
  • To assess heart failure severity using clinical, biochemical, and echocardiographic parameters.
  • To provide local data from Bangladesh on this comorbidity.

Main Methods:

  • A hospital-based observational study included 120 adult HFpEF patients.
  • Patients were categorized into iron-deficient (n=60) and iron-replete (n=60) groups.
  • Severity was assessed via NYHA class, NT-proBNP levels, and diastolic dysfunction grading.

Main Results:

  • Iron-deficient patients were older and had higher rates of anemia.
  • Significant associations were found between iron deficiency and higher NYHA class, elevated NT-proBNP, and more severe diastolic dysfunction.
  • Grade 3 diastolic dysfunction was more prevalent in the iron-deficient group.

Conclusions:

  • Iron deficiency correlates with increased HFpEF severity across multiple assessment domains.
  • Age and anemia prevalence were baseline differences that may influence the unadjusted association.
  • Routine iron status assessment in HFpEF patients in Bangladesh is recommended, pending further multicenter studies.

Keywords:
bangladeshdiastolic dysfunctionheart failure with preserved ejection fractioniron deficiencynt-probnpnyha functional class

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