| Disordered iron homeostasis in chronic heart failure prevalence, predictors, and relation to anemia, exercise capacity, and survival. | |
| | |
MedLine Citation:
|
PMID: 21903058 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
|
OBJECTIVES: The aim of this study was to comprehensively delineate iron metabolism and its implications in patients with chronic heart failure (CHF). BACKGROUND: Iron deficiency is an emerging therapeutic target in CHF. METHODS: Iron and clinical indexes were quantified in 157 patients with CHF. RESULTS: Several observations were made. First, iron homeostasis was deranged in anemic and nonanemic subjects and characterized by diminished circulating (transferrin saturation) and functional (mean cell hemoglobin concentration) iron status in the face of seemingly adequate stores (ferritin). Second, while iron overload and elevated iron stores were rare (1%), iron deficiency (transferrin saturation <20%) was evident in 43% of patients. Third, disordered iron homeostasis related closely to worsening inflammation and disease severity and strongly predicted lower hemoglobin levels independently of age, sex, erythrocyte sedimentation rate, New York Heart Association (NYHA) functional class, and creatinine. Fourth, the etiologies of anemia varied with disease severity, with an iron-deficient substrate (anemia of chronic disease and/or iron-deficiency anemia) evident in 16%, 72%, and 100% of anemic NYHA functional class I or II, III, and IV patients, respectively. Although anemia of chronic disease was more prevalent than iron-deficiency anemia, both conditions coexisted in 17% of subjects. Fifth, iron deficiency was associated with lower peak oxygen consumption and higher ratios of ventilation to carbon dioxide production and identified those at enhanced risk for death (hazard ratio: 3.38; 95% confidence interval: 1.48 to 7.72; p = 0.004) independently of hemoglobin. Nonanemic iron-deficient patients had a 2-fold greater risk for death than anemic iron-replete subjects. CONCLUSIONS: Disordered iron homeostasis in patients with CHF relates to impaired exercise capacity and survival and appears prognostically more ominous than anemia. |
| | |
Authors:
|
Darlington O Okonko; Amit K J Mandal; Constantinos G Missouris; Philip A Poole-Wilson |
Related Documents
:
|
3792748 - Effect of cricopharyngeal myotomy on pharyngoesophageal function: pre- and postoperativ... 9362188 - Reduced chemoreceptor sensitivity in patients with barrett's esophagus may be related t... 3973778 - Upper airway lesions in children after accidental ingestion of caustic substances. 22347348 - Hepcidin: a useful marker in chronic obstructive pulmonary disease. 7053588 - Technique of venous impedance plethysmography for quantification of venous reflux. 8458158 - Gait performance after spinal cord injury. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Journal of the American College of Cardiology Volume: 58 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2011 Sep |
Date Detail:
|
Created Date: 2011-09-09 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
|
Languages: eng Pagination: 1241-51 Citation Subset: AIM; IM |
Copyright Information:
|
Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Affiliation:
|
Clinical Cardiology, National Heart & Lung Institute, Imperial College London, London, United Kingdom. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Enhanced rho-kinase activity in circulating neutrophils of patients with vasospastic angina a possib...
Next Document: Sudden death in young adults an autopsy-based series of a population undergoing active surveillance.