3.8 Article

Pathophysiology and Treatment Opportunities of Iron Deficiency in Heart Failure: Is There a Need for Further Trials?

相关参考文献

注意:仅列出部分参考文献,下载原文获取全部文献信息。
Article Cardiac & Cardiovascular Systems

Impact of ferric carboxymaltose for iron deficiency at discharge after heart failure hospitalization: a European multinational economic evaluation

Phil McEwan et al.

Summary: The study assessed the burden of disease and pharmacoeconomic implications of treating iron deficiency in patients with acute heart failure. The findings indicate that treatment with FCM can reduce hospitalizations and bed days, leading to savings in healthcare resources and improvement in quality of life for heart failure patients.

EUROPEAN JOURNAL OF HEART FAILURE (2023)

Editorial Material Cardiac & Cardiovascular Systems

Combining Iron Supplements With SGLT2 Inhibitor- Stimulated Erythropoiesis in Heart Failure: Should We Be Worried About Thromboembolic Events?

Milton Packer et al.

JOURNAL OF CARDIAC FAILURE (2023)

Article Economics

Clinical and economic impact of ferric carboxymaltose treatment for iron deficiency in patients stabilized following acute heart failure: a multinational study

Phil McEwan et al.

Summary: This study evaluates the financial implications of introducing ferric carboxymaltose (FCM) for treating acute heart failure patients in the UK, Switzerland, and Italy. The findings suggest that FCM could lead to cost savings in the healthcare systems of these countries.

JOURNAL OF MEDICAL ECONOMICS (2023)

Article Cardiac & Cardiovascular Systems

Potential Interactions When Prescribing SGLT2 Inhibitors and Intravenous Iron in Combination in Heart Failure

Milton Packer

Summary: In patients with heart failure, the use of SGLT2 inhibitors can lead to worsening absolute iron deficiency, but it is not caused by poor dietary intake or gastrointestinal bleeding. There are two possible explanations for the observed changes in iron homeostasis proteins. According to the cytosolic iron depletion hypothesis, SGLT2 inhibitors decrease hepcidin and ferritin and increase transferrin receptor due to drug-induced erythropoietin-related increase in iron use. According to the cytosolic iron repletion hypothesis, SGLT2 inhibitors decrease hepcidin and ferritin and increase transferrin receptor by reversing inflammation-related increases in hepcidin and ferritin and increasing sirtuin-1 signaling.

JACC-HEART FAILURE (2023)

Article Cardiac & Cardiovascular Systems

Association Between Hemoglobin Levels and Efficacy of Intravenous Ferric Carboxymaltose in Patients With Acute Heart Failure and Iron Deficiency: An AFFIRM-AHF Subgroup Analysis

Gerasimos Filippatos et al.

Summary: Iron deficiency, with or without anemia, is a negative prognostic factor in heart failure. In a randomized trial, intravenous ferric carboxymaltose (FCM) reduced the risk of heart failure hospitalization and improved quality of life in iron-deficient patients stabilized after an acute heart failure episode. Subanalyses showed that the effects of FCM did not differ based on hemoglobin levels.

CIRCULATION (2023)

Article Cardiac & Cardiovascular Systems

Iron deficiency in pulmonary vascular disease: pathophysiological and clinical implications

Pieter Martens et al.

Summary: Iron deficiency is common in pulmonary hypertension, but its clinical significance and optimal definition remain unclear. This study analyzed data from 1028 patients and found that the heart failure definition of iron deficiency endorsed by pulmonary hypertension guidelines did not identify patients with lower exercise capacity or functional status. However, defining iron deficiency as transferrin saturation (TSAT) <21% identified patients with lower exercise capacity, worse functional status, right heart remodeling, and adverse clinical outcomes.

EUROPEAN HEART JOURNAL (2023)

Review Cardiac & Cardiovascular Systems

Iron deficiency and cardiovascular disease

Gianluigi Savarese et al.

Summary: Iron deficiency is common in patients with cardiovascular disease, especially coronary artery disease and heart failure. Various factors contribute to the development of iron deficiency, such as inadequate dietary iron, chronic inflammation, and increased blood loss. For patients with heart failure, iron deficiency is an important therapeutic target, even in the absence of anemia.

EUROPEAN HEART JOURNAL (2023)

Article Cardiac & Cardiovascular Systems

Effect of intravenous iron replacement on recurrent heart failure hospitalizations and cardiovascular mortality in patients with heart failure and iron deficiency: a Bayesian meta-analysis

Stefan D. Anker et al.

Summary: Iron deficiency is common in patients with heart failure and reduced ejection fraction, and it is associated with a poor prognosis. The effect of intravenous iron replacement on recurrent heart failure hospitalizations and cardiovascular mortality in these patients is uncertain. This study used a Bayesian analysis to provide precise estimates of the effect of intravenous iron replacement and found that it significantly reduced the rates of recurrent heart failure hospitalizations and cardiovascular mortality.

EUROPEAN JOURNAL OF HEART FAILURE (2023)

Article Cardiac & Cardiovascular Systems

Magnetic resonance imaging of organ iron before and after correction of iron deficiency in patients with heart failure

Christoph Gertler et al.

Summary: This study analyzed the changes in iron signal and exercise capacity in chronic heart failure patients before and after intravenous iron therapy. The findings showed that patients with iron deficiency had lower iron content in the spleen, liver, and heart. After intravenous iron therapy, the iron content in the left ventricle, spleen, and liver increased. Improvement in exercise capacity was associated with an increase in hemoglobin levels after intravenous iron therapy.

ESC HEART FAILURE (2023)

Review Medicine, General & Internal

Micronutrient deficiencies in heart failure: Mitochondrial dysfunction as a common pathophysiological mechanism?

Nils Bomer et al.

Summary: There is a clear relationship between poor cardiac performance, metabolic perturbations, and heart failure. Micronutrient deficiency has a high impact on mitochondrial energy production in heart failure patients. Supplementation with micronutrients may be a potential therapeutic strategy in the treatment of heart failure.

JOURNAL OF INTERNAL MEDICINE (2022)

Review Medicine, General & Internal

Iron Deficiency in Heart Failure: Mechanisms and Pathophysiology

Ridha I. S. Alnuwaysir et al.

Summary: Iron deficiency is a common comorbidity in heart failure patients and can have negative effects on exercise capacity, quality of life, hospitalization rates, and mortality risks. Intravenous iron correction has shown promising results in improving symptoms and reducing hospitalizations in heart failure patients. However, the underlying pathophysiology of iron deficiency in heart failure is still poorly understood.

JOURNAL OF CLINICAL MEDICINE (2022)

Article Medicine, General & Internal

Intravenous ferric derisomaltose in patients with heart failure and iron deficiency in the UK (IRONMAN) : an investigator-initiated, prospective, randomised, open-label, blinded-endpoint trial

Paul R. Kalra et al.

Summary: This study evaluated the long-term effects of intravenous ferric derisomaltose on cardiovascular events in patients with heart failure. The results showed that treatment with ferric derisomaltose was associated with a lower risk of hospital admissions for heart failure and cardiovascular death, further supporting the benefit of iron repletion in this patient population.

LANCET (2022)

Article Cardiac & Cardiovascular Systems

Impact of ischaemic aetiology on the efficacy of intravenous ferric carboxymaltose in patients with iron deficiency and acute heart failure: insights from the AFFIRM-AHF trial

Marco Metra et al.

Summary: In the AFFIRM-AHF study, intravenous ferric carboxymaltose (FCM) was found to reduce heart failure hospitalizations and cardiovascular deaths in patients with ischemic HF but not in those with non-ischemic HF. FCM also showed a nominal improvement in quality of life. Further studies are needed to assess the impact of etiology on FCM efficacy.

EUROPEAN JOURNAL OF HEART FAILURE (2022)

Article Cardiac & Cardiovascular Systems

Rationale and design of a randomised trial of intravenous iron in patients with heart failure

Paul R. Kalra et al.

Summary: The INTRONMAN trial evaluated the benefits and safety of intravenous iron treatment in the long-term management of heart failure patients with iron deficiency.
Review Environmental Sciences

Iron Deficiency and Deranged Myocardial Energetics in Heart Failure

Michal Tkaczyszyn et al.

Summary: Among different pathomechanisms involved in the development of heart failure, adverse metabolic myocardial remodeling closely related to ineffective energy production constitutes the fundamental feature of the disease. Iron, as a component of key enzymatic machineries, plays a vital role in energy generation and utilization. By correcting iron deficiency, it may be possible to influence the energetic efficiency of tissues, including the heart. This review summarizes current knowledge on disturbed energy metabolism in failing hearts and analyzes experimental evidence linking iron deficiency with deranged myocardial energetics.

INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH (2022)

Review Hematology

Intravenous iron: do we adequately understand the short- and long-term risks in clinical practice?

Deborah Rund

Summary: Intravenous iron is commonly used as a therapeutic agent for iron deficiency and iron-restricted anaemia, with newer forms of iron leading to more regular and higher dose usage. However, inconsistencies exist in the literature regarding its adverse effects, including the risk of hypophosphataemia. Recent insights on infection risk, iron handling by macrophages, and potential risks of iron overload due to IV iron are also discussed.

BRITISH JOURNAL OF HAEMATOLOGY (2021)

Article Cardiac & Cardiovascular Systems

Oral sucrosomial iron improves exercise capacity and quality of life in heart failure with reduced ejection fraction and iron deficiency: a non-randomized, open-label, proof-of-concept study

Apostolos Karavidas et al.

Summary: In this study involving 25 patients with heart failure and iron deficiency, oral sucrosomial iron (SI) was found to significantly increase levels of hemoglobin, serum iron, and serum ferritin, while also improving exercise capacity and quality of life. No deaths occurred during the study period, indicating that SI was well tolerated. Further randomized studies are needed to confirm these findings.

EUROPEAN JOURNAL OF HEART FAILURE (2021)

Article Cardiac & Cardiovascular Systems

Hospital readmissions of patients with heart failure from real world: timing and associated risk factors

Maria Wideqvist et al.

Summary: This study investigated hospital readmissions and risk factors in patients with heart failure (HF) in the real world setting. It found that frequent readmissions occurred early post-discharge, mainly driven by worsening HF and comorbidities. Psychiatric disease and poor medication compliance were identified as independent risk factors for readmission.

ESC HEART FAILURE (2021)

Review Cardiac & Cardiovascular Systems

Iron deficiency in heart failure

Goran Loncar et al.

Summary: Iron deficiency is a common co-morbidity in heart failure patients, and can be improved through parenteral iron supplementation therapy to enhance patient health and physical performance. Intravenous iron preparations have shown superior clinical effect in previous trials.

ESC HEART FAILURE (2021)

Review Nutrition & Dietetics

Relevance of nutritional assessment and treatment to counteract cardiac cachexia and sarcopenia in chronic heart failure

Antia Fernandez-Pombo et al.

Summary: Chronic heart failure often leads to involuntary weight loss and muscle wasting, necessitating careful nutritional evaluation and treatment to prevent or improve cardiac cachexia and sarcopenia, as well as improve the course of the disease.

CLINICAL NUTRITION (2021)

Article Cardiac & Cardiovascular Systems

2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

Theresa A. McDonagh et al.

EUROPEAN HEART JOURNAL (2021)

Article Cardiac & Cardiovascular Systems

Ferric carboxymaltose for the treatment of iron deficiency in heart failure: a multinational cost-effectiveness analysis utilising AFFIRM-AHF

Phil McEwan et al.

Summary: The study found that treatment with ferric carboxymaltose was cost-saving with additional health gains in the UK, USA, and Switzerland, and highly cost-effective in Italy. This was mainly driven by reduced costs for heart failure events combined with quality-adjusted life-year gains, resulting in better functional outcomes for patients.

EUROPEAN JOURNAL OF HEART FAILURE (2021)

Review Urology & Nephrology

Iron Deficiency in Chronic Kidney Disease: Updates on Pathophysiology, Diagnosis, and Treatment

Elizabeth Katherine Batchelor et al.

JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY (2020)

Article Hematology

Intravenous iron: a framework for changing the management of iron deficiency

Michael Auerbach et al.

Lancet Haematology (2020)

Review Biochemistry & Molecular Biology

Intravenous iron supplementation therapy

Benedikt Schaefer et al.

MOLECULAR ASPECTS OF MEDICINE (2020)

Article Cardiac & Cardiovascular Systems

Intravenous iron therapy in heart failure: a different perspective

Kambiz Ghafourian et al.

EUROPEAN JOURNAL OF HEART FAILURE (2019)

Article Urology & Nephrology

Novel Oral Iron Therapies for Iron Deficiency Anemia in Chronic Kidney Disease

Pablo E. Pergola et al.

ADVANCES IN CHRONIC KIDNEY DISEASE (2019)

Review Biochemistry & Molecular Biology

Micronutrient Depletion in Heart Failure: Common, Clinically Relevant and Treatable

Natasa Cvetinovic et al.

INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES (2019)

Review Cardiac & Cardiovascular Systems

Structural and functional abnormalities in iron-depleted heart

Kamil A. Kobak et al.

HEART FAILURE REVIEWS (2019)

Review Cardiac & Cardiovascular Systems

Iron Deficiency in Heart Failure An Overview

Stephan von Haehling et al.

JACC-HEART FAILURE (2019)

Review Medicine, General & Internal

Parenteral versus oral iron therapy for adults and children with chronic kidney disease

Emma L. O'Lone et al.

COCHRANE DATABASE OF SYSTEMATIC REVIEWS (2019)

Article Cardiac & Cardiovascular Systems

Myocardial iron content and mitochondrial function in human heart failure: a direct tissue analysis

Vojtech Melenovsky et al.

EUROPEAN JOURNAL OF HEART FAILURE (2017)

Review Urology & Nephrology

The available intravenous iron formulations: History, efficacy, and toxicology

Michael Auerbach et al.

HEMODIALYSIS INTERNATIONAL (2017)

Article Cardiac & Cardiovascular Systems

Impaired hepato-renal function defined by the MELD XI score as prognosticator in acute heart failure

Jan Biegus et al.

EUROPEAN JOURNAL OF HEART FAILURE (2016)

Review Cardiac & Cardiovascular Systems

Effects of intravenous iron therapy in iron-deficient patients with systolic heart failure: a meta-analysis of randomized controlled trials

Ewa A. Jankowska et al.

EUROPEAN JOURNAL OF HEART FAILURE (2016)

Review Cardiac & Cardiovascular Systems

Iron therapy for the treatment of iron deficiency in chronic heart failure: intravenous or oral?

Theresa McDonagh et al.

EUROPEAN JOURNAL OF HEART FAILURE (2015)

Article Cardiac & Cardiovascular Systems

Iron status in patients with chronic heart failure

Ewa A. Jankowska et al.

EUROPEAN HEART JOURNAL (2013)

Review Cardiac & Cardiovascular Systems

Micronutrient Deficiencies An Unmet Need in Heart Failure

Victor Soukoulis et al.

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY (2009)

Article Endocrinology & Metabolism

The emerging role of the gut in chronic heart failure

Anja Sandek et al.

CURRENT OPINION IN CLINICAL NUTRITION AND METABOLIC CARE (2008)

Article Cardiac & Cardiovascular Systems

Effect of intravenous iron sucrose on exercise tolerance in anemic and nonanemic patients with symptomatic chronic heart failure and iron deficiency

Darlington O. Okonko et al.

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY (2008)

Article Cardiac & Cardiovascular Systems

Intravenous iron reduces NT-Pro-Brain natriuretic peptide in anemic patients with chronic heart failure and renal insufficiency

Jorge Eduardo Toblli et al.

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY (2007)