Iron deficiency in patients with heart failure with preserved ejection fraction and its association with reduced exercise capacity, muscle strength ... View Full Text


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Article Info

DATE

2019-02

AUTHORS

Tarek Bekfani, Pierpaolo Pellicori, Daniel Morris, Nicole Ebner, Miroslava Valentova, Anja Sandek, Wolfram Doehner, John G. Cleland, Mitja Lainscak, P. Christian Schulze, Stefan D. Anker, Stephan von Haehling

ABSTRACT

BACKGROUND: The prevalence of iron deficiency (ID) in outpatients with heart failure with preserved ejection fraction (HFpEF) and its relation to exercise capacity and quality of life (QoL) is unknown. METHODS: 190 symptomatic outpatients with HFpEF (LVEF 58 ± 7%; age 71 ± 9 years; NYHA 2.4 ± 0.5; BMI 31 ± 6 kg/m2) were enrolled as part of SICA-HF in Germany, England and Slovenia. ID was defined as ferritin < 100 or 100-299 µg/L with transferrin saturation (TSAT) < 20%. Anemia was defined as Hb < 13 g/dL in men, < 12 g/dL in women. Low ferritin-ID was defined as ferritin < 100 µg/L. Patients were divided into 3 groups according to E/e' at echocardiography: E/e' ≤ 8; E/e' 9-14; E/e' ≥ 15. All patients underwent echocardiography, cardiopulmonary exercise test (CPX), 6-min walk test (6-MWT), and QoL assessment using the EQ5D questionnaire. RESULTS: Overall, 111 patients (58.4%) showed ID with 89 having low ferritin-ID (46.84%). 78 (41.1%) patients had isolated ID without anemia and 54 patients showed anemia (28.4%). ID was more prevalent in patients with more severe diastolic dysfunction: E/e' ≤ 8: 44.8% vs. E/e': 9-14: 53.2% vs. E/e' ≥ 15: 86.5% (p = 0.0004). Patients with ID performed worse during the 6MWT (420 ± 137 vs. 344 ± 124 m; p = 0.008) and had worse exercise time in CPX (645 ± 168 vs. 538 ± 178 s, p = 0.03). Patients with low ferritin-ID had lower QoL compared to those without ID (p = 0.03). CONCLUSION: ID is a frequent co-morbidity in HFpEF and is associated with reduced exercise capacity and QoL. Its prevalence increases with increasing severity of diastolic dysfunction. More... »

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1-9

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URI

http://scigraph.springernature.com/pub.10.1007/s00392-018-1344-x

DOI

http://dx.doi.org/10.1007/s00392-018-1344-x

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1105856283

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30051186


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    "description": "BACKGROUND: The prevalence of iron deficiency (ID) in outpatients with heart failure with preserved ejection fraction (HFpEF) and its relation to exercise capacity and quality of life (QoL) is unknown.\nMETHODS: 190 symptomatic outpatients with HFpEF (LVEF 58\u2009\u00b1\u20097%; age 71\u2009\u00b1\u20099 years; NYHA 2.4\u2009\u00b1\u20090.5; BMI 31\u2009\u00b1\u20096\u00a0kg/m2) were enrolled as part of SICA-HF in Germany, England and Slovenia. ID was defined as ferritin\u2009<\u2009100 or 100-299\u00a0\u00b5g/L with transferrin saturation (TSAT)\u2009<\u200920%. Anemia was defined as Hb\u2009<\u200913\u00a0g/dL in men, <\u200912\u00a0g/dL in women. Low ferritin-ID was defined as ferritin\u2009<\u2009100\u00a0\u00b5g/L. Patients were divided into 3 groups according to E/e' at echocardiography: E/e'\u2009\u2264\u20098; E/e' 9-14; E/e'\u2009\u2265\u200915. All patients underwent echocardiography, cardiopulmonary exercise test (CPX), 6-min walk test (6-MWT), and QoL assessment using the EQ5D questionnaire.\nRESULTS: Overall, 111 patients (58.4%) showed ID with 89 having low ferritin-ID (46.84%). 78 (41.1%) patients had isolated ID without anemia and 54 patients showed anemia (28.4%). ID was more prevalent in patients with more severe diastolic dysfunction: E/e'\u2009\u2264\u20098: 44.8% vs. E/e': 9-14: 53.2% vs. E/e'\u2009\u2265\u200915: 86.5% (p\u2009=\u20090.0004). Patients with ID performed worse during the 6MWT (420\u2009\u00b1\u2009137 vs. 344\u2009\u00b1\u2009124\u00a0m; p\u2009=\u20090.008) and had worse exercise time in CPX (645\u2009\u00b1\u2009168 vs. 538\u2009\u00b1\u2009178\u00a0s, p\u2009=\u20090.03). Patients with low ferritin-ID had lower QoL compared to those without ID (p\u2009=\u20090.03).\nCONCLUSION: ID is a frequent co-morbidity in HFpEF and is associated with reduced exercise capacity and QoL. Its prevalence increases with increasing severity of diastolic dysfunction.", 
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