title: Myocardial iron homeostasis in advanced chronic heart failure patients.
abstract: BACKGROUND
  Although, correction of iron deficiency and/or anemia in heart failure (HF) with iron seems promising, little is known about myocardial iron load and homeostasis. Moreover iron supplementation indications are solely based on iron serum markers. The purpose was to assess myocardial iron (M-Iron), ferritin (M-FR), transferrin receptor (M-sTfR) in HF in relation to serum Iron markers.
  
  
  RESULTS
  Study group 33 patients, left/right ventricle (LV/RV) (LVEDV 245 ± 84 ml; LVESV 189 ± 85 ml; LVEF 22 ± 11%; RVD 32 ± 10 mm), NTproBNP (5464 ± 4825 pg/ml). Iron homeostasis assessment serum: iron, FR, transferrin/saturation (TSAT), sTfR; myocardial: M-Iron (Instrumental Neutron Activation Analysis, μg/g), M-FR, M-sTfR (ELISA - ng/mg protein) in the explanted failing hearts (FH), compared to non-failing hearts (NFH n=11). In FH as compared to NFH, M-Iron was reduced in RV (174 ± 45 vs 233 ± 97, respectively, p=0.07), LV (189 ± 58 vs 265 ± 119, p=0.04), without significant changes in M-FR/M-sTfR. Out of all serum iron markers only sTfR was negatively correlated with M-Iron in either ventricle (RV r=-0.44, p=0.03, LV r=-0.38, p=0.07). With regard to serum iron status, based on TSAT, patients were divided into two subgroups: reduced (TSAT<15%; n=11) and not-reduced serum iron (TSAT ≥ 15%; n=22). Both subgroups had similar grade of LV/RV dysfunction, NT-proBNP levels. M-FR was lower in TSAT<15% than in TSAT ≥ 15% (LV -31 ± 26 vs 46 ± 29; p=0.07) and (RV -24 ± 24 vs 43 ± 29; p=0.02), without differences in M-Iron and M-sTfR.
  
  
  CONCLUSIONS
  In HF, M-Iron levels were reduced. Serum iron markers did not reflect M-Iron levels, except for serum sTfR. In reduced serum iron group, decrease in myocardial storage protein M-FR was observed.
authors: Institute of Cardiology, ul. Alpejska 42, 04-628 Warszawa, Poland. przemyslaw.leszek@ikard.pl
authors: Przemysław
authors: P
authors: Leszek
authors: Barbara
authors: B
authors: Sochanowicz
authors: Małgorzata
authors: M
authors: Szperl
authors: Piotr
authors: P
authors: Kolsut
authors: Kamil
authors: K
authors: Brzóska
authors: Walerian
authors: W
authors: Piotrowski
authors: Tomasz M
authors: TM
authors: Rywik
authors: Bożena
authors: B
authors: Danko
authors: Halina
authors: H
authors: Polkowska-Motrenko
authors: Jacek M
authors: JM
authors: Różański
authors: Marcin
authors: M
authors: Kruszewski
mesh_terms: D000328:Adult; D002908:Chronic Disease; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000378:metabolism*; D006706:Homeostasis / Q000502:physiology*; D006801:Humans; D007501:Iron / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D007501:Iron