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Title: | Impact of iron deficiency on exercise capacity and outcome in heart failure with reduced, mid-range and preserved ejection fraction | Authors: | MARTENS, Pieter NIJST, Petra VERBRUGGE, Frederik Smeets, Kevin DUPONT, Matthias MULLENS, Wilfried |
Issue Date: | 2018 | Source: | ACTA CARDIOLOGICA, 73(2), p. 115-123 | Abstract: | Background: Little information is available about the prevalence and impact on exercise capacity and outcome of iron deficiency in heart failure with mid-range (HFmrEF) and preserved (HFpEF) ejection fraction in comparison to heart failure with reduced ejection-fraction (HFrEF). Furthermore, no data is available about the progression of ID in patients without baseline anaemia. Methods: We evaluated baseline iron and haemoglobin-status in a single-centre, prospective heart failure database. Baseline functional status, VO2max, echocardiography and clinical-outcome (all-cause mortality and heart failure admissions) were evaluated. ID, anaemia, HFrEF, HFmrEF and HFpEF were defined according to established criteria. Results: A total of 1197 patients (71% male) were evaluated (HFrEF, n=897; HFmrEF, n=229; HFpEF, n=72). The overall prevalence of ID was 53% (50% in HFrEF; 61% in HFmrEF; 64% in HFpEF) and 36% for anaemia. ID was associated with a lower VO2max in patients with HFrEF, HFmrEF and HFpEF (p<.001 in all). Iron status more closely related to a poor VO2max than anaemia status (p<.001). Furthermore, poor clinical-outcome was more strongly associated with iron status than anaemia status. Exposing eight patients without anaemia to iron deficiency for 39 months resulted in one patient developing new-onset anaemia (defined as progression of ID). Patients with progression of ID exhibited a significant higher risk of heart failure hospitalisation and all-cause mortality (HR=1.4; CI=1.01-1.94; p=.046) than patients without progression. Conclusions: Iron deficiency is common in patients with HFrEF, HFmrEF and HFpEF, and negatively affects VO2max and clinical-outcome. Progression of iron deficiency parallels an increased risk for worsening of heart failure. | Notes: | Mullens, W (reprint author), Ziekenhuis Oost Limburg, Dept Cardiol, Schiepse Bos 6, B-3600 Genk, Belgium. Wilfried.Mullens@zol.be | Keywords: | iron deficiency; exercise capacity; outcome; heart failure | Document URI: | http://hdl.handle.net/1942/26604 | Link to publication/dataset: | https://www.researchgate.net/profile/Pieter_Martens/publication/318637512_Impact_of_iron_deficiency_on_exercise_capacity_and_outcome_in_heart_failure_with_reduced_mid-range_and_preserved_ejection_fraction/links/5b2971a0aca27209f324a075/Impact-of-iron-deficiency-on-exercise-capacity-and-outcome-in-heart-failure-with-reduced-mid-range-and-preserved-ejection-fraction.pdf?origin=publication_detail | ISSN: | 0001-5385 | e-ISSN: | 1784-973X | DOI: | 10.1080/00015385.2017.1351239 | ISI #: | 000431104400002 | Rights: | (C) 2017 Belgian Society of Cardiology | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2019 |
Appears in Collections: | Research publications |
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