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Review
. 2022 Oct 16;14(10):e30348.
doi: 10.7759/cureus.30348. eCollection 2022 Oct.

Iron Deficiency in Heart Failure: What Do We Know So Far?

Amr Elkammash  1 , Rasha M Farahat  2 , Aya Al Sattouf  2 , Julius Lenaerts  3 , Khin Yadanar Maung  3 , Aayesha Khatri  4
Affiliations
Review

Iron Deficiency in Heart Failure: What Do We Know So Far?

Amr Elkammash et al. Cureus. .

Abstract

Iron is vital for multiple biological processes in the human body. Heart failure (HF) patients are at a high risk of becoming iron deficient. Iron deficiency is a marker of severe HF and an ominous sign of poor outcomes. Iron deficiency can be absolute (low iron stores) or functional (improper functioning in the metabolic processes). The European Society of Cardiology recommends routine screening of iron stores in HF patients using ferritin and transferrin saturation. It advises iron replacement in deficient patients irrespective of the presence of anemia. Iron replacement improved HF symptoms, exercise capacity, and quality of life in deficient patients. It alleviates their disordered breathing during sleep. Therefore, the treatment of iron deficiency is an important target in managing HF. Oral iron is not effective in repleting iron stores in HF patients. Intravenous iron is an effective way to replenish iron stores in this cohort.

Keywords: anemia; deficiency; ferric carboxymaltose; heart failure; heart failure with preserved ejection fraction (hfpef); heart failure with reduced ejection fraction; iron; metabolism.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Iron metabolism at the cellular level.
The figure is created by the author Julius Lenaerts. Adapted from von Haehling et al. [5].
Figure 2
Figure 2. Types of iron deficiency and its effects on the body systems.
The figure is created by the author Julius Lenaerts. Adapted from Loncar et al. [10].
Figure 3
Figure 3. Diagnosis, treatment, and follow-up of iron deficiency in heart failure patients.
The figure is created by the author Julius Lenaerts. Adapted from Loncar et al. [10].
See this image and copyright information in PMC

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