PMID- 23178646
OWN - NLM
STAT- MEDLINE
DCOM- 20130905
LR  - 20240322
IS  - 1522-9645 (Electronic)
IS  - 0195-668X (Print)
IS  - 0195-668X (Linking)
VI  - 34
IP  - 11
DP  - 2013 Mar
TI  - Iron status in patients with chronic heart failure.
PG  - 827-34
LID - 10.1093/eurheartj/ehs377 [doi]
AB  - AIMS: The changes in iron status occurring during the course of heart failure 
      (HF) and the underlying pathomechanisms are largely unknown. Hepcidin, the major 
      regulatory protein for iron metabolism, may play a causative role. We 
      investigated iron status in a broad spectrum of patients with systolic HF in 
      order to determine the changes in iron status in parallel with disease 
      progression, and to associate iron status with long-term prognosis. METHODS AND 
      RESULTS: Serum concentrations of ferritin, transferrin saturation (Tsat), soluble 
      transferrin receptor (sTfR), and hepcidin were assessed as the biomarkers of iron 
      status in 321 patients with chronic systolic HF [age: 61 +/- 11 years, men: 84%, 
      left ventricular ejection fraction: 31 +/- 9%, New York Heart Association (NYHA) 
      class: 72/144/87/18] at a tertiary cardiology centre and 66 age- and 
      gender-matched healthy subjects. Compared with healthy subjects, asymptomatic HF 
      patients had similar haematological status, but increased iron stores (evidenced 
      by higher serum ferritin without distinct inflammation, P < 0.01) with markedly 
      elevated serum hepcidin (P < 0.001). With increasing HF severity, patients in 
      advanced NYHA classes had iron deficiency (ID) (reduced serum ferritin, low Tsat, 
      high sTfR), iron-restricted erythropoiesis (reduced haemoglobin, high red cell 
      distribution width), and inflammation (high serum high-sensitivity-C-reactive 
      protein and interleukin 6), which was accompanied by decreased circulating 
      hepcidin (all P < 0.001). In multivariable Cox models, low hepcidin was 
      independently associated with increased 3-year mortality among HF patients (P < 
      0.001). CONCLUSIONS: Increased level of circulating hepcidin characterizes an 
      early stage of HF, and is not accompanied by either anaemia or inflammation. The 
      progression of HF is associated with the decline in circulating hepcidin and the 
      development of ID. Low hepcidin independently relates to unfavourable outcome.
FAU - Jankowska, Ewa A
AU  - Jankowska EA
AD  - Laboratory for Applied Research of Cardiovascular System, Department of Heart 
      Diseases, Faculty of Health Sciences, Wroclaw Medical University, ul. Weigla 5, 
      50-981 Wroclaw, Poland. ewa.jankowska@am.wroc.pl
FAU - Malyszko, Jolanta
AU  - Malyszko J
FAU - Ardehali, Hossein
AU  - Ardehali H
FAU - Koc-Zorawska, Ewa
AU  - Koc-Zorawska E
FAU - Banasiak, Waldemar
AU  - Banasiak W
FAU - von Haehling, Stephan
AU  - von Haehling S
FAU - Macdougall, Iain C
AU  - Macdougall IC
FAU - Weiss, Guenter
AU  - Weiss G
FAU - McMurray, John J V
AU  - McMurray JJ
FAU - Anker, Stefan D
AU  - Anker SD
FAU - Gheorghiade, Mihai
AU  - Gheorghiade M
FAU - Ponikowski, Piotr
AU  - Ponikowski P
LA  - eng
GR  - K02 HL107448/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20121123
PL  - England
TA  - Eur Heart J
JT  - European heart journal
JID - 8006263
RN  - 0 (Antimicrobial Cationic Peptides)
RN  - 0 (Biomarkers)
RN  - 0 (HAMP protein, human)
RN  - 0 (Hepcidins)
RN  - 0 (Transferrin)
RN  - 9007-73-2 (Ferritins)
SB  - IM
MH  - Anemia, Iron-Deficiency/blood/etiology/mortality
MH  - Antimicrobial Cationic Peptides/*metabolism
MH  - Biomarkers/metabolism
MH  - Case-Control Studies
MH  - Chronic Disease
MH  - Disease Progression
MH  - Female
MH  - Ferritins/metabolism
MH  - Heart Failure, Systolic/blood/*etiology/mortality
MH  - Hepcidins
MH  - Humans
MH  - *Iron Deficiencies
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Transferrin/metabolism
PMC - PMC3697803
EDAT- 2012/11/28 06:00
MHDA- 2013/09/06 06:00
PMCR- 2014/03/14
CRDT- 2012/11/27 06:00
PHST- 2012/11/27 06:00 [entrez]
PHST- 2012/11/28 06:00 [pubmed]
PHST- 2013/09/06 06:00 [medline]
PHST- 2014/03/14 00:00 [pmc-release]
AID - ehs377 [pii]
AID - 10.1093/eurheartj/ehs377 [doi]
PST - ppublish
SO  - Eur Heart J. 2013 Mar;34(11):827-34. doi: 10.1093/eurheartj/ehs377. Epub 2012 Nov 
      23.