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Is iron important in heart failure?


Authors: Ján Murín;  Miroslav Pernický
Authors‘ workplace: I. interná klinika LF UK a UN Bratislava, Slovenská republika, prednostka doc. MUDr. Soňa Kiňová, CSc.
Published in: Vnitř Lék 2015; 61(Suppl 5): 50-55
Category: Reviews

Overview

Iron deficiency is a frequent comorbidity in a patient with chronic heart failure, and it associates with a worse pro­gnosis of that patient. Mainly worse quality of life and more rehospitalizations are in these iron deficient patients. Iron metabolism is rather complex and there is some new information concerning this complexity in heart failure. We distinquish an absolute and a functional iron deficiency in heart failure. It is this deficit which is important and not as much is anemia important here. Prevalence of anaemia in heart failure is about 30–50 %, higher it is in patients suffering more frequently heart failure decompensations. Treatment of iron deficiency is important and it improves prognosis of these patients. Most experiences there are with i.v. iron treatment (FERRIC HF, FAIR HF and CONFIRM HF studies), less so with per oral treatment. There are no clinical trials which analysed mortality influences.

Key words:
heart failure – iron metabolism in heart failure – prevalence of iron deficit – treatment of iron deficiency in heart failure


Sources

1. Schaufelberger M, Swedberg K, Koster M et al. Decreasing one-year mortality and hospitalization rates for heart failure in Sweden; data from the Swedish Hospital Discharge Registry 1988 to 2000. Eur Heart J 2004; 25(4): 300–307.

2. Meta-Analysis Global Group In Chronic heart failure (MAGGIC). The survival of patients with heart failure with preserved or reduced left ventricular ejection fraction: an individual patient data meta-analysis. Eur Heart J 2012; 33(14): 1750–1757.

3. Klip IT, Comin-Colet J, Voors AA et al. Iron deficiency in chronic heart failure: an international pooled analysis. Am Heart J 2013; 165(4): 575–582.

4. Brownlie TT, Utermohlen V, Hinton PS et al. Tissue iron deficiency without anemia impairs adaptation in endurance capacity after aerobic training in previously untrained women. Am J Clin Nutr 2004; 79(3): 437–443.

5. Hinton PS, Giordano C, Brownlie T et al. Iron supplementation improves endurance after training in iron-depleted, nonanemic women. J Appl Physiol 2000; 88(3): 1103–1111.

6. Murín J, Papinčák J, Pernický M et al. Anémia a srdcové zlyhávanie – ako pristupovať k liečbe pacienta? Cardiol Lett 2013; 22(5): 405–407.

7. Okonko DO, Mandal AK, Missouris CG et al. Disordered iron homeostatis in chronic heart failure: prevalence, predictors, and relation to anemia, exercise capacity, and survival. J Am Coll Cardiol 2011; 58(12): 1241–1251.

8. Ganz T. Hepcidin, a key regulator of iron metabolism and mediator of anemia of inflammation. Blood 2003; 102(3): 783–788.

9. Jankowska EA, von Haehling S, Anker SK et al. Iron deficiency and heart failure: diagnostic dilemmas and therapeutic perspectives. Eur Heart J 2013; 34(11): 816–829.

10. Jankowska EA, Malyszko J, Ardehali H et al. Iron status in patients with chronic heart failure. Eur Heart J 2013; 34(11): 827–834.

11. Chua AC, Graham RM, Trinder D et al. The regulation of cellular iron metabolism. Crit Rev Clin Lab Sci 2007; 44(5–6): 413–459.

12. Čermák J Léčba anémie a nedostatku železa z pohledu hematologa. Kardiol Rev Int Med 2014; 16(5): 359–363.

13. Cohen-Solal A, Leclercq C, Deray G et al. Iron deficiency: an emerging therapeutic target in heart failure. Heart 2014; 100(18): 1414–1420.

14. Nemeth E, Valore EV, Territo M et al. Hepcidin, a putative mediator of anemia of inflammation, is a type II acute-phase protein. Blood 2003; 101(7): 2461–2463.

15. Suzuki T, Hanawa H, Jiao S et al. Inapproprite expression of hepcidin by liver congestion contributes to anemia and relative iron deficiency. J Card Fail 2014; 20(4): 268–277.

16. Hsieh YP, Huang CH, Lee CY et al. Silencing of hepcidin enforces the apoptosis in iron-induced human cardiomyocytes. J Occup Med Toxicol 2014; 9(1): 11. Dostupné z DOI: <http://doi: 10.1186/1745–6673–9-11>.

17. Maeder MT, Khammy O, dos Remedios C et al. Myocardial and systemic iron depletion in heart failure: implications for anemia accompanying heart failure. J Am Coll Cardiol 2011; 58(5): 474–480.

18. Coenen JL, van Dieijen-Visser MP, van Pelt J et al. Measurements of serum ferritin used to predict concentrations of iron in bone marrow in anemia of chronic disease. Clin Chem 1991; 37(4): 560–563.

19. Cohen-Solal A, Leclercq C, Mebazaa A et al. Diagnosis and treatment of iron deficiency in patients with heart failure: Expert position paper from French cardiologists. Arch Cardiovasc Dis 2014; 107(10): 563–571.

20. Čermák J, Gregora E, Lachmanová J et al. Sledování zásob železa u nemocných s chronickým selháním ledvin léčených rekombinantním lidským erytropoetinem. Vnitř Lék 1994; 40(3): 174–178.

21. Ebner N, von Haehling S. Iron deficiency in heart failure: a practical guide. Nutrients 2013; 5(9): 3730–3739.

22. Jankowska EA, Kasztura M, Sokolski M et al. Iron deficiency defined as depleted iron stores accompanied by unmet cellular iron requirements identifies patients at the highest risk of death after an episode of acute heart failure. Eur. Heart J 2014; 35(36): 2468–2476.

23. Leszek P, Sochanowicz B, Szperl M et al. Myocardial iron homeostasis in advanced chronic heart failure patients. Int J Cardiol 2012; 159(1): 47–52.

24. Yeo TJ, Yeo PS, Ching-Chiew Wong R et al. Iron deficiency in a multi-ethnic Asian population with and without heart failure: prevalence,clinical correlates, functional signifikance and prognosis. Eur J Heart Fail 2014; 16(10):1125–1132.

25. Jankowska EA, Rozentryt P, Witkowska A et al. Iron deficiency: an ominous sign in patients with systolic chronic heart failure. Eur Heart J 2010; 31(15): 1872–1880.

26. Cohen-Solal A, Damy T, Terbah M et al. High prevalence of iron deficiency in patients with acute decompensated heart failure. Eur J Heart Fail 2014; 16(9): 984–991.

27. Nanas JN, Matsouka C, Karageorgopoulos D et al. Etiology of anemia in patients with advanced heart failure. J Am Coll Cardiol 2006; 48(12): 2485–2489.

28. Fitzsimons S, Doughty RN. Iron deficiency in patients with heart failure. Eur Heart J Cardiovasc Pharmacotherapy 2015; 1(1): 58–64.

29. Weiss G, Goodnough LT. Anemia of chronic disease. N Engl J Med 2005; 352(10): 1011–1023.

30. Weber CS, Beck-da-Silva L, Goldraich LA et al. Anemia in heart failure: association of hepcidin levels to iron deficiency in stable outpatients. Acta Haematol 2013; 129(1): 55–61.

31. Dong F, Zhang X, Culver B et al. Dietary iron deficiency induces ventricular dilation, mitochondrial ultrastructural aberrations and cytochrome C release: involvement of nitric oxide synthase and protein tyrosine nitration. Clin Sci (Scand) 2005; 109(3): 277–286.

32. Comin-Colet J, Enjuanes C, Gonzalez G et al. Iron deficiency is a key determinant of health-related quality of life in patients with chronic heart failure regardless of anaemia status. Eur J Heart fail 2013; 15(10): 1164–1172.

33. Enjuanes C, Klip IT, Bruguera J et al. Iron deficiency and health-related quality of life in chronic heart failure: results from a multicenter European study. Int J Cardiol 2014; 174(2): 268–275.

34. Jankowska EA, Rozentryt P, Witkowska A et al. Iron deficiency predicts impaired exercise capacity in patients with systolic chronic heart failure. J Card Fail 2011; 17(11): 899–906.

35. Vítovec J, Špinar J, Špinarová L. Léčba anémie a nedostatku železa u chronického srdečního selháni. Kardiol Rev Int Med 2014; 16(5): 364–369.

36. Hradec J. Anémie při chronickém srdečním selhání. Vnitř Lék 2010; 56(8): 854–859.

37. Bolger AP, Bartlett FR, Penston HS et al. Intravenous iron alone for the treatment of anemia in patients with chronic heart failure. J Am Coll Cardiol 2006; 48(6): 1225–1227.

38. Toblli JE, Lombrana A, Duarte P et al. Intravenous iron reduces NT-pro-brain natriuretic peptide in anemic patients with chronic heart failure and renal insufficiency. J Am Coll Cardiol 2007; 50(17): 1657–1665.

39. Okonko DO, Grzeslo A, Witkowski T et al. Effect of intravenous iron sucrose on exercise tolerance in anemic and nonanemic patients with symptomatic chronic heart failure and iron deficiency. FERRIC-HF: a randomized, controlled, observer-blinded trial. J Am Coll Cardiol 2008; 51(2): 103–112.

40. Anker SD, Comin Colet J, Filippatos G et al. Ferric carboxymaltose in patients with heart failure and iron deficiency. N Engl J Med 2009;361(25): 2436–2448

41. Comin-Colet J, Lainscak M, Dickstein K et al. The effect of intravenous ferric carboxymaltose on health-related quality of life in patients with chronic heart failure and iron deficiency: a subanalysis of the FAIR-HF Study. Eur Heart J 2013; 34(1): 30–38.

42. Filippatos G, Farmakis D, Colet JC et al. Intravenous ferric carboxymaltose in iron-deficient chronic heart failure patients with and without anaemia: a subanalysis of the FAIR-HF trial. Eur J Heart Fail 2013; 15(11): 1267–1276.

43. Ponikowski P, van Veldhuisen DJ, Comin-Colet J et al. Beneficial effects of long-term intravenous iron therapy with ferric carboxymaltose in patients with symptomatic heart failure and iron deficiency. Eur Heart J 2015; 36(11): 657–668.

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Diabetology Endocrinology Internal medicine
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