Iron deficiency in patients with HFpEF was associated with a higher risk of combined all-cause mortality and HF hospitalization over 4 years (log rank P=0.008).
Cohort (n=300)
Does iron deficiency worsen prognosis and exercise capacity in patients with heart failure with preserved ejection fraction?
In patients with HFpEF, iron deficiency is associated with a worse long-term prognosis regarding mortality and heart failure hospitalization, though its apparent impact on exercise capacity is multifactorial and confounded by comorbidities like pulmonary hypertension.
p-value: p=0.008
AIMS: Whether and how iron deficiency (ID) impacts patients with heart failure (HF) with preserved ejection fraction (HFpEF) remain unclear. The aim of our study was to investigate the impact of ID on functional status, exercise capacity, and prognosis in HFpEF. METHODS AND RESULTS: The study population consisted of 300 HFpEF patients. ID was defined as serum ferritin <100 μg/L or 100-300 μg/L and transferrin-saturation <20%. Baseline functional status, quality of life (HADS score and EQ 5D index), 6 min walking test, echocardiography, and outcome (all-cause mortality and combined all cause-mortality and HF hospitalization) were evaluated. ID was found in 159 (53%) patients. Patients with ID had a worse prognosis with a higher combined endpoint of all-cause mortality and HF hospitalization after 4 years of follow-up (log rank = 0.008). Pulmonary hypertension, depression, and thyroid disease were more prevalent in the ID group. Multivariable analysis showed that ID was independently associated with body mass index (P = 0.003), pulmonary hypertension (P = 0.008), and thyroid disease (P = 0.01). Although patients with ID had a lower exercise capacity compared with patients without ID (393 m 294-455 vs. 344 m 260-441, P = 0.008), there was no significant correlation after multivariable correction for age, BMI, NT-proBNP, DM, and depression. CONCLUSIONS: Heart failure with preserved ejection fraction patients with ID have a worse prognosis and impaired exercise capacity compared with those without ID. However, although a trend was observed, after multivariable correction ID was no longer significantly associated with a reduced exercise capacity. This reflects that impaired exercise capacity in HFpEF is complex and seems multifactorial. Interestingly, pulmonary hypertension was an independent predictor of both ID and exercise capacity.
Aizpurua et al. (Sun,) conducted a cohort in Heart failure with preserved ejection fraction (HFpEF) (n=300). Iron deficiency vs. No iron deficiency was evaluated on Combined all-cause mortality and HF hospitalization (p=0.008). Iron deficiency in patients with HFpEF was associated with a higher risk of combined all-cause mortality and HF hospitalization over 4 years (log rank P=0.008).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: