Open AccessImpact of intravenous ferric carboxymaltose on heart failure with preserved and reduced ejection fraction
Author(s) -
LópezVilella Raquel,
LozanoEdo Silvia,
Arenas Martín Patricia,
JoverPastor Pablo,
Ezzitouny Meryem,
Sorolla Romero José,
Calvo Asensio María,
MartínezSolé Julia,
Guerrero Cervera Borja,
Sánchez Martínez José Carlos,
Donoso Trenado Víctor,
SánchezLázaro Ignacio,
Martinez Dolz Luis,
Almenar Bonet Luis
Publication year - 2022
Publication title -
esc heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.787
H-Index - 25
ISSN - 2055-5822
DOI - 10.1002/ehf2.13753
Subject(s) - medicine , ejection fraction , heart failure , ferritin , interquartile range , cardiology , transferrin saturation , iron deficiency , anemia , serum ferritin
Aims Heart failure (HF) is a proinflammatory disease often associated with the onset of iron deficiency (ID). ID alters mitochondrial function, reducing the generation of cellular energy in skeletal muscle and cardiomyocytes. This study aimed to analyse the response of patients with HF to intravenous iron administration according to the type of HF: preserved ejection fraction (HFpEF) or reduced ejection fraction (HFrEF). Methods and results We conducted a retrospective, single‐centre study of 565 consecutive outpatients diagnosed with HF, recruited over 5 years, who were given intravenous ferric carboxymaltose (FCM) for the treatment of ID [defined as ferritin < 100 μg/L or ferritin 100–300 μg/L with transferrin saturation (TSAT) < 20%]. Clinical, laboratory, and echocardiographic parameters were analysed before and after administration. After FCM administration, overall ferritin, TSAT, and haemoglobin levels increased up to 5‐fold, 1.6‐fold, and 1.1‐fold, respectively, relative to baseline values in HF patients with reduced and preserved ejection fraction ( P < 0.0001), with a greater increase in ferritin and TSAT in HFpEF patients. The left ventricular ejection fraction of the overall series improved by 8 percentage points in both types of HF (from 40% to 48%, P < 0.0001). The percentage of patients with normalization of right ventricular function increased by 6.9 points (from 74.1% to 81%) in HFpEF patients and by 6.4 points (from 53% to 59.4%) in the HFrEF subgroup ( P < 0.0001). New York Heart Association functional status slightly improved, from a median of 2.4 (interquartile range, IQR: 2–2.7) to 1.9 (IQR: 1.5–2.5; P < 0.0001) after FCM in both types of HF. No changes were noted in plasma levels of liver enzymes, creatinine, or natriuretic peptide ( P > 0.05). Conclusions Intravenous iron administration appeared to improve ejection fraction and cardiac functional status in outpatients with ID and HF with both preserved and reduced ejection fraction.