Abstract

Every cell requires iron as a necessary cofactor for the activity of several enzymes involved in key cellular processes like oxidative metabolic process, DNA and RNA synthesis, and microRNA (miRNAs) biogenesis. Moreover, iron plays a fundamental role in oxygen transport and storage as a component of hemoglobin and myoglobin, respectively. Therefore, due to its fundamental role in physiology, iron uptake by the organism and iron cellular transport is a tightly regulated process and its unbalance is associated with diseases including heart failure (HF) [ [1] Alnuwaysir R.I.S. Hoes M.F. van Veldhuisen D.J. van der Meer P. Beverborg N.G. Iron deficiency in heart failure: mechanisms and pathophysiology. J. Clin. Med. MDPI. 2022; 11 Google Scholar ]. Among others, inflammatory cellular and molecular factors are strong iron metabolism influencers, thus pathological conditions characterized by a complex imbalance in inflammation such as HF could benefit from iron-target preventive/therapeutic strategies and several clinical trials are investigating this possibility. The results of these trials could impact a large population since about 50% of outpatients with HF and almost 80% of acute ones experience iron deficiency (ID), the condition in which the availability of iron is insufficient to meet the body’s needs [ [2] Cappellini M.D. Comin-Colet J. de Francisco A. Dignass A. Doehner W. Lam S.P.C. et al. Iron deficiency across chronic inflammatory conditions: international expert opinion on definition, diagnosis, and management. Vol. 92. in: American Journal of Hematology. Wiley-Liss Inc, 2017: 1068-1078 Crossref Scopus (232) Google Scholar , [3] Lam C.S.P. Doehner W. Comin-Colet J. Cappellini M.D. Camaschella C. de Francisco A. et al. Iron deficiency in chronic heart failure: case-based practical guidance. in: ESC Heart Failure. 5. Wiley-Blackwell, 2018: 764-771 Crossref Scopus (40) Google Scholar ]. ID occurs with or without anemia and it is associated with a worsening in the quality of life, enhanced risk of hospitalization, and reduced life expectancy of HF patients [ [1] Alnuwaysir R.I.S. Hoes M.F. van Veldhuisen D.J. van der Meer P. Beverborg N.G. Iron deficiency in heart failure: mechanisms and pathophysiology. J. Clin. Med. MDPI. 2022; 11 Google Scholar ].

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