title: Iron deficiency: an emerging therapeutic target in heart failure.
abstract: In patients with heart failure, iron deficiency is frequent but overlooked, with a prevalence of 30%-50%. Since it contributes to cardiac and peripheral muscle dysfunction, iron deficiency is associated with poorer clinical outcomes and a greater risk of death, independent of haemoglobin level. Therefore, iron deficiency emerges as a new comorbidity and a therapeutic target of chronic heart failure in addition to chronic renal insufficiency, anaemia and diabetes. In a series of placebo-controlled, randomised studies in patients with heart failure and iron deficiency, intravenous iron had a favourable effect on exercise capacity, functional class, LVEF, renal function and quality of life. These clinical studies were performed in the context of a renewed interest in iron metabolism. During the past 10 years, knowledge about the transport, storage and homeostasis of iron has improved dramatically, and new molecules involved in iron metabolism have been described (eg, hepcidin, ferroportin, divalent metal transporter 1). Recent European guidelines recommend the monitoring of iron parameters (ie, serum ferritin, transferrin saturation) for all patients with heart failure. Ongoing clinical trials will explore the benefits of iron deficiency correction on various heart failure parameters.
authors: Department of Cardiology, Lariboisière Hospital, AP-HP, Paris, France.
authors: Alain
authors: A
authors: Cohen-Solal
authors: Department of Cardiology and Vascular Disease, Pontchaillou Hospital, Rennes, France.
authors: Christophe
authors: C
authors: Leclercq
authors: Department of Nephrology, Pitié-Salpêtrière Hospital, Paris, France.
authors: Gilbert
authors: G
authors: Deray
authors: Department of Anesthesia and Critical Care Medicine, CHU Angers, Angers, France.
authors: Sigismond
authors: S
authors: Lasocki
authors: Department of Internal Medicine, Bichat-Claude Bernard Hospital, AP-HP, Paris, France.
authors: Jean-Jacques
authors: JJ
authors: Zambrowski
authors: Department of Anesthesia and Critical Care Medicine, Lariboisière Hospital, AP-HP, Paris, France.
authors: Alexandre
authors: A
authors: Mebazaa
authors: Pôle Cardiologie et Médecine Vasculaire, Hôpital Cardiologique, CHRU Lille, Lille, France.
authors: Pascal
authors: P
authors: de Groote
authors: Department of Cardiology, Henri-Mondor Hospital, AP-HP, Créteil, France.
authors: Thibaud
authors: T
authors: Damy
authors: Department of Cardiology, CHU Rangueil, Toulouse, France.
authors: Michel
authors: M
authors: Galinier
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D000818:Animals; D015415:Biomarkers / Q000097:blood; D002908:Chronic Disease; D015897:Comorbidity; D019587:Dietary Supplements; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D006397:Hematinics / Q000627:therapeutic use*; D006801:Humans; D007501:Iron / Q000097:blood / Q000627:therapeutic use*; D000090463:Iron Deficiencies; D015995:Prevalence; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D006397:Hematinics; D007501:Iron
keywords: Heart Failure