Intravenous iron repletion in heart failure patients with reduced ejection fraction and iron deficiency significantly improved left ventricular global longitudinal strain from -8.5% to -9.3%.
Observational (n=98)
Single-blind
No
Does intravenous ferric carboxymaltose improve echocardiographic parameters of myocardial performance in heart failure patients with LVEF ≤50% and iron deficiency?
Absolute Event Rate: -9.3% vs -8.5%
p-value: p=<0.05
Abstract Iron deficiency (ID) is a prevalent comorbidity in heart failure (HF) patients associated with poor prognosis and impaired physical capacity. Functional limitations linked to ID may be related to cardiac function abnormalities, which could be reversible with iron repletion. Some echocardiographic parameters, such as global longitudinal strain (GLS), myocardial work (MW), and its derivatives constructive work (CW), wasted work (WW), and work efficiency (WE), may provide additive value in advanced cardiac performance assessment. The IRON-PATH II was a multicenter, prospective and observational study designed to describe pathophysiological pathways associated to ID. The echo-substudy included 100 HF patients undergoing a specific pilot echocardiographic evaluation. Patients had left ventricular ejection fraction (LVEF) ≤50%, were in stable clinical condition, on standard HF medication, and with hemoglobin ≥11 g/dL. The final cohort included 98 patients. The ID group showed worse cardiac function, with lower GLS (–8.5±9% vs –10±10%), WE (74±10% vs 80±10%), and MW (665453-1013 vs 947542-1199 mmHg%), as well as higher WW (290228-384 vs 212138-305 mmHg%) and lower RV free wall strain (–13-20-(–11) % vs –17-23-(–14) %). Following iron repletion, ID patients demonstrated improved LV (GLS, MW, WE, and WW) and RV performance (RV free wall strain), aligning with non-ID patients (all p-values >0.05 compared to the non-ID group). In conclusion, among HF patients with reduced LVEF, ID was associated with worse myocardial performance in both the LV and RV, with these alterations being reversible after intravenous iron repletion. Abstract Figure Graphical Abstract
Ramos-Polo et al. (2025) conducted an observational in Heart failure with reduced ejection fraction and iron deficiency (n=98). Intravenous ferric carboxymaltose vs. Baseline (pre-treatment) was evaluated on Change in global longitudinal strain (GLS) (p=<0.05). Intravenous iron repletion in heart failure patients with reduced ejection fraction and iron deficiency significantly improved left ventricular global longitudinal strain from -8.5% to -9.3%.