title: Iron deficiency is a key determinant of health-related quality of life in patients with chronic heart failure regardless of anaemia status.
abstract: OBJECTIVE
  To evaluate the effect of iron deficiency (ID) and/or anaemia on health-related quality of life (HRQoL) in patients with chronic heart failure (CHF).
  
  
  RESULTS
  We undertook a post-hoc analysis of a cohort of CHF patients in a single-centre study evaluating cognitive function. At recruitment, patients provided baseline information and completed the Minnesota Living with Heart Failure questionnaire (MLHFQ) for HRQoL (higher scores reflect worse HRQoL). At the same time, blood samples were taken for serological evaluation. ID was defined as serum ferritin levels <100 ng/mL or serum ferritin <800 ng/mL with transferrin saturation <20%. Anaemia was defined as haemoglobin ≤12 g/dL. A total of 552 CHF patients were eligible for inclusion, with an average age of 72 years and 40% in NYHA class III or IV. The MLHFQ overall summary scores were 41.0 ± 24.7 among those with ID, vs. 34.4 ± 26.4 for non-ID patients (P = 0.003), indicating worse HRQoL. When adjusted for other factors associated with HRQoL, ID was significantly associated with worse MLHFQ overall summary (P = 0.008) and physical dimension scores (P = 0.002), whereas anaemia was not (both P > 0.05). Increased levels of soluble transferrin receptor were also associated with impaired HRQoL (P ≤ 0.001). Adjusting for haemoglobin and C-reactive protein, ID was more pronounced in patients with anaemia compared with those without (P < 0.001).
  
  
  CONCLUSIONS
  In patients with CHF, ID but not anaemia was associated with reduced HRQoL, mostly due to physical factors.
authors.affiliation: Heart Failure Programme, Department of Cardiology, Hospital del Mar, Barcelona, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Comín-Colet
authors.forename: Cristina
authors.initials: C
authors.lastname: Enjuanes
authors.forename: Gina
authors.initials: G
authors.lastname: González
authors.forename: Ainhoa
authors.initials: A
authors.lastname: Torrens
authors.forename: Mercè
authors.initials: M
authors.lastname: Cladellas
authors.forename: Oona
authors.initials: O
authors.lastname: Meroño
authors.forename: Nuria
authors.initials: N
authors.lastname: Ribas
authors.forename: Sonia
authors.initials: S
authors.lastname: Ruiz
authors.forename: Miquel
authors.initials: M
authors.lastname: Gómez
authors.forename: José Maria
authors.initials: JM
authors.lastname: Verdú
authors.forename: Jordi
authors.initials: J
authors.lastname: Bruguera
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018798:Anemia, Iron-Deficiency / Q000150:complications / Q000503:physiopathology*; D016022:Case-Control Studies; D002908:Chronic Disease; D017079:Exercise Tolerance; D005221:Fatigue / Q000209:etiology; D005260:Female; D005293:Ferritins / Q000097:blood; D006304:Health Status; D006333:Heart Failure / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D007501:Iron / Q000097:blood; D000090463:Iron Deficiencies; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D012720:Severity of Illness Index; D014168:Transferrin / Q000378:metabolism
chemical_list: D014168:Transferrin; D005293:Ferritins; D007501:Iron
keywords: Anaemia; Health-related quality of life; Iron deficiency