Abstract
Iron deficiency is prevalent in chronic heart failure (CHF) patients. Nonetheless, the diagnosis is often overlooked and, often, the treatment is commenced just when overt anemia has ensued. Therefore, a better appreciation of this disease is needed, and all seasoned cardiologists should know how to approach CHF patients with iron deficiency correctly, as mandated by clinical practice guidelines. In this comprehensive review, we describe iron homeostasis, the pathophysiologic changes of iron homeostasis, and the clinical implications of iron deficiency on CHF patients. In addition, we delineate the evolution of clinical trials, ranging from the inception to the ongoing clinical trials of iron deficiency treatment in CHF patients. Iron deficiency contributes to the worse clinical outcome of the patients. Numerous studies have reported the clinical benefit of iron supplementation, particularly in intravenous preparation, in heart failure patients regarding symptoms, functional capacity, and quality of life (QoL) improvement. Therefore, the current guidelines recommend routine screening of iron status in all newly diagnosed heart failure patients. Eventually, intravenous iron replacement is recommended for symptomatic heart failure patients with iron deficiency, irrespective of anemia.
Highlights
BackgroundHeart failure is one of the most important cardiovascular diseases owing to its significant impact on mortality, morbidity, hospitalization rates, and quality of life (QoL) [1]
We describe iron homeostasis, the pathophysiologic changes of iron homeostasis, and the clinical implications of iron deficiency on chronic heart failure (CHF) patients
Numerous studies have reported the clinical benefit of iron supplementation, in intravenous preparation, in heart failure patients regarding symptoms, functional capacity, and quality of life (QoL) improvement
Summary
Heart failure is one of the most important cardiovascular diseases owing to its significant impact on mortality, morbidity, hospitalization rates, and quality of life (QoL) [1]. At the end of the 24-week monitoring, the group with intravenous iron had a significant increase in hemoglobin and serum ferritin levels This increase in iron level is accompanied by clinical improvement in heart failure patients, including improvement in symptoms, improvement in functional capacity (50% in the iron group and 28% in the placebo group; p
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