Author + information
- Received March 23, 2018
- Revision received June 29, 2018
- Accepted July 2, 2018
- Published online December 12, 2018.
- Stephan von Haehling, MD, PhDa,∗ (, )
- Nicole Ebner, PhDa,
- Ruben Evertz, MDa,
- Piotr Ponikowski, MD, PhDb and
- Stefan D. Anker, MD, PhDc,d
- aDepartment of Cardiology and Pneumology, University of Göttingen Medical Center, Göttingen, Germany
- bDepartment of Heart Diseases, Wroclaw Medical University, Centre for Heart Diseases, Military Hospital, Wroclaw, Poland
- cDivision of Cardiology and Metabolism-Heart Failure, Cachexia and Sarcopenia, Department of Cardiology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Berlin, Germany
- dBerlin-Brandenburg Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Berlin, Germany
- ↵∗Address for correspondence:
Prof. Stephan von Haehling, Department of Cardiology and Pneumology, University of Göttingen Medical School, Robert-Koch-Strasse 40, D-37075 Göttingen, Germany.
Iron deficiency is an extremely common co-morbidity in patients with heart failure, affecting up to 50% of all ambulatory patients. It is associated with reduced exercise capacity and physical well-being and reduced quality of life. Cutoff values have been identified for diagnosing iron deficiency in heart failure with reduced ejection fraction as serum ferritin, <100 μg/l, or ferritin, 100 to 300 μg/l, with transferrin saturation of <20%. Oral iron products have been shown to have little efficacy in heart failure, where the preference is intravenous iron products. Most clinical studies have been performed using ferric carboxymaltose with good efficacy in terms of improvements in 6-min walk test distance, peak oxygen consumption, quality of life, and improvements in New York Heart Association functional class. Data from meta-analyses also suggest beneficial effects for hospitalization rates for heart failure and reduction in cardiovascular mortality rates. A prospective trial to investigate effects on morbidity and mortality is currently ongoing. This article highlights current knowledge of the pathophysiology of iron deficiency in heart failure, its prevalence and clinical impact, and its possible treatment options.
Dr. von Haehling has consulted for Vifor Pharma, Roche, Bayer, Brahms; and has received speakers fees from Boehringer Ingelheim, Novartis, Chugai Pharma, and Amgen. Dr. Anker has consulted for Vifor Pharma, Boehringer Ingelheim, Bayer, Servier Pharmaceuticals, and Novartis; and has received grants through his institution from Vifor Pharma, IIT, and Abbott Vascular. The other authors have reported that they have no relationships with industry relevant to the contents of this paper to disclose.
- Received March 23, 2018.
- Revision received June 29, 2018.
- Accepted July 2, 2018.
- 2018 American College of Cardiology Foundation
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