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Perspective

Iron deficiency in heart failure: more than just fatigue

Andrew Sindone

Figures

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Abstract

About half of patients with heart failure (HF) have iron deficiency (ID), which can occur without anaemia and can cause exacerbated symptoms and increased hospitalisation and mortality. Intravenous iron therapy improves symptoms and quality of life, and may improve survival in patients with HF and ID.

Key Points

  • Iron deficiency (ID) in heart failure (HF) is common and under-diagnosed.
  • ID in patients with HF is not necessarily related to anaemia.
  • ID causes increasing dyspnoea, deterioration in exercise capacity, fatigue, worse left ventricular function, higher rates of hospitalisation and increased mortality in patients with HF.
  • Oral and intramuscular iron have no evidence of benefit in treating patients with HF and ID and are not recommended.
  • Intravenous infusion of ferric carboxymaltose in patients with HF and ID can improve exercise capacity, quality of life, left ventricular function and may reduce HF hospitalisations and possibly improve survival.

Figures

© IVCANDY/ISTOCKPHOTO.COM; SKINY25/ISTOCKPHOTO.COM
© IVCANDY/ISTOCKPHOTO.COM; SKINY25/ISTOCKPHOTO.COM