title: Absolute and Functional Iron Deficiency Is a Common Finding in Patients With Heart Failure and After Heart Transplantation.
abstract: BACKGROUND
  Anemia is relatively common in patients with heart failure and heart transplant recipients. Both absolute and functional iron deficiency may contribute to the anemia in these populations. Functional iron deficiency (defined as ferritin greater than 200 ng/mL with TSAT (Transferrin saturation) less than 20%) is characterized by the presence of adequate iron stores as defined by conventional criteria, but with insufficient iron mobilization to adequately support. The aim of this study was to determine prevalence of absolute and functional iron deficiency in patients with heart failure (n = 269) and after heart transplantation (n = 130) and their relation to parameters of iron status and inflammation.
  
  
  METHODS
  Iron status, complete blood count, and creatinine levels were assessed using standard laboratory methods. C-reactive protein, hepcidin and hemojuvelin were measured using commercially available kits.
  
  
  RESULTS
  Absolute iron deficiency was present in 15% of patients with heart failure and 30% in heart transplant recipients, whereas functional iron deficiency was present in 18% of patients with heart failure and 17% in heart transplant recipients. Functional iron deficiency was associated with significantly higher C-reactive protein and hepcidin levels in heart failure patients, and higher hepcidin and lower estimate glomerular filtration rates in heart transplant recipients. Prevalence of anemia (according to the World Health Organization) was significantly higher in heart transplant recipients (40% vs 22%, P < .001), they were also younger, but with worse kidney function than patients with heart failure.
  
  
  CONCLUSIONS
  Both absolute and functional iron deficiency were present in a considerable group of patients. This population should be carefully screened for possible reversible causes of inflammation.
authors.affiliation: Department of Cardiac Surgery and Transplantology, Collegium Medicum, Jagiellonian University, Cracow, Poland.
authors.forename: P
authors.initials: P
authors.lastname: Przybylowski
authors.affiliation: Department of Cardiac Surgery and Transplantology, Collegium Medicum, Jagiellonian University, Cracow, Poland. Electronic address: grzegorz.wa@interia.pl.
authors.forename: G
authors.initials: G
authors.lastname: Wasilewski
authors.affiliation: Department of Invasive Cardiology, Medical University, Bialystok, Poland.
authors.forename: K
authors.initials: K
authors.lastname: Golabek
authors.affiliation: Department of Invasive Cardiology, Medical University, Bialystok, Poland.
authors.forename: H
authors.initials: H
authors.lastname: Bachorzewska-Gajewska
authors.affiliation: Department of Invasive Cardiology, Medical University, Bialystok, Poland.
authors.forename: S
authors.initials: S
authors.lastname: Dobrzycki
authors.affiliation: 2nd Department of Nephrology, Medical University, Bialystok, Poland.
authors.forename: E
authors.initials: E
authors.lastname: Koc-Zorawska
authors.affiliation: 2nd Department of Nephrology, Medical University, Bialystok, Poland.
authors.forename: J
authors.initials: J
authors.lastname: Malyszko
mesh_terms: D000328:Adult; D000368:Aged; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D005293:Ferritins / Q000097:blood / Q000172:deficiency; D058851:GPI-Linked Proteins / Q000097:blood; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000097:blood* / Q000150:complications; D016027:Heart Transplantation; D000071020:Hemochromatosis Protein; D064451:Hepcidins / Q000097:blood; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000209:etiology; D007501:Iron / Q000097:blood; D000090463:Iron Deficiencies; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D015995:Prevalence
chemical_list: D058851:GPI-Linked Proteins; C481006:HJV protein, human; D000071020:Hemochromatosis Protein; D064451:Hepcidins; D002097:C-Reactive Protein; D005293:Ferritins; D007501:Iron