Document Detail

Iron deficiency predicts impaired exercise capacity in patients with systolic chronic heart failure.
MedLine Citation:
PMID:  22041326     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: Iron is an indispensable element of hemoglobin, myoglobin, and cytochromes, and, beyond erythropoiesis, is involved in oxidative metabolism and cellular energetics. Hence, iron deficiency (ID) is anticipated to limit exercise capacity. We investigated whether ID predicted exercise intolerance in patients with systolic chronic heart failure (CHF).
METHODS AND RESULTS: We prospectively studied 443 patients with stable systolic CHF (age 54 ± 10 years, males 90%, ejection fraction 26 ± 7%, New York Heart Association Class I/II/III/IV 49/188/180/26). ID was defined as: serum ferritin <100 μg/L or serum ferritin 100-300 μg/L with serum transferrin saturation <20%. Exercise capacity was expressed as peak oxygen consumption (VO(2)) and ventilatory response to exercise (VE-VCO(2) slope). ID was present in 35 ± 4% (±95% confidence interval) of patients with systolic CHF. Those with ID had reduced peak VO(2) and increased VE-VCO(2) slope as compared to subjects without ID (peak VO(2): 13.3 ± 4.0 versus 15.3 ± 4.5 mL•min•kg, VE-VCO(2) slope: 50.9 ± 15.8 versus 43.1 ± 11.1, respectively, both P < .001, P < .05). In multivariable models, the presence of ID was associated with reduced peak VO(2) (β = -0.14, P < .01 P < .05) and higher VE-VCO(2) slope (β = 0.14, P < .01 P < .05), adjusted for demographics and clinical variables. Analogous associations were found between serum ferritin, and both peak VO(2) and VE-VCO(2) slope (P < .05).
CONCLUSIONS: ID independently predicts exercise intolerance in patients with systolic CHF, but the strength of these associations is relatively weak. Whether iron supplementation would improve exercise capacity in iron-deficient subjects requires further studies.
Ewa A Jankowska; Piotr Rozentryt; Agnieszka Witkowska; Jolanta Nowak; Oliver Hartmann; Beata Ponikowska; Ludmila Borodulin-Nadzieja; Stephan von Haehling; Wolfram Doehner; Waldemar Banasiak; Lech Polonski; Gerasimos Filippatos; Stefan D Anker; Piotr Ponikowski
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiac failure     Volume:  17     ISSN:  1532-8414     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  899-906     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland; Centre for Heart Diseases, Military Hospital, Wroclaw, Poland.
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