PMID- 35016401
OWN - NLM
STAT- MEDLINE
DCOM- 20220113
LR  - 20220113
IS  - 2224-5839 (Electronic)
IS  - 2224-5820 (Linking)
VI  - 10
IP  - 12
DP  - 2021 Dec
TI  - Iron deficiency is an independent risk factor of increased myocardial energy 
      expenditure in chronic heart failure patients.
PG  - 12061-12071
LID - 10.21037/apm-21-2297 [doi]
AB  - BACKGROUND: Chronic heart failure (CHF) is a major public health burden and is 
      associated with high morbidity, mortality, and cost. Recent studies demonstrated 
      iron metabolism and myocardial energy metabolism were altered in CHF patients. In 
      this study, we aimed to analyze the effects and correlations of iron metabolism 
      on myocardial energy metabolism in CHF. METHODS: One hundred and thirty patients 
      with CHF [age: 66.2+/-11.5 years, males: 58.5% and New York Heart Association 
      (NYHA) class (II/III/IV): 67/43/20] were included. Serum concentrations of 
      ferritin, transferrin saturation (Tsat), and soluble transferrin receptor (sTfR) 
      were quantified as the indexes of iron metabolism, and echocardiography was used 
      to assess myocardial energy expenditure (MEE) levels. Iron deficiency (ID) was 
      defined as ferritin <100 or 100-300 microg/L with Tsat <20%. RESULTS: Patients with 
      CHF were divided into two groups based on iron status. The prevalence of ID in 
      CHF was 36.9%, and increased with the severity of CHF, reaching 80.0% in those 
      with NYHA class IV (NYHA class II/III/IV: 17.9% vs. 46.5% vs. 80.0%, P=0.000). 
      The demographic characteristics [age, sex, body mass index (BMI), blood pressure, 
      and heart rate] and hemoglobin (HGB) concentrations in two groups were similar 
      (all P>0.05). MEE was significantly higher in the ID group (92.7+/-23.0 vs. 
      65.6+/-20.8 cal/min, P=0.000), while NYHA classes II and III was significantly 
      higher in the ID group (71.6+/-16.4 vs. 60.3+/-14.8 cal/min, P=0.022; 88.9+/-10.4 vs. 
      69.1+/-20.1 cal/min, P=0.000). In univariable linear regression models, the 
      presence of ID, higher NYHA class, increased N-terminal pro-B-type natriuretic 
      peptide (NT-proBNP), sTfR, left ventricular internal diastolic diameter (LVIDd), 
      as well as reduced ferritin, Tsat levels, and lower left ventricular ejection 
      fraction (LVEF) were associated with elevated MEE levels (all P<0.05). In 
      multivariable regression models, the presence of ID, reduced Tsat. and increased 
      sTfR remained independent predictors of elevated MEE levels after adjustment for 
      all variables that showed a significant association with MEE (all P<0.05). 
      CONCLUSIONS: The prevalence of ID is high in CHF and is associated with the 
      severity of cardiac dysfunction. The presence of ID as well as reduced Tsat and 
      increased sTfR concentrations are associated with elevated MEE levels in CHF.
FAU - Lin, Feng
AU  - Lin F
AD  - State Key Laboratory of Organ Failure Research, Department of Cardiology, Nanfang 
      Hospital, Southern Medical University, Guangzhou, China; Department of 
      Cardiology, Shenzhen People's Hospital, Shenzhen, China.
FAU - Huang, Yuli
AU  - Huang Y
AD  - State Key Laboratory of Organ Failure Research, Department of Cardiology, Nanfang 
      Hospital, Southern Medical University, Guangzhou, China.
FAU - An, Dongqi
AU  - An D
AD  - State Key Laboratory of Organ Failure Research, Department of Cardiology, Nanfang 
      Hospital, Southern Medical University, Guangzhou, China.
FAU - Zhan, Qiong
AU  - Zhan Q
AD  - State Key Laboratory of Organ Failure Research, Department of Cardiology, Nanfang 
      Hospital, Southern Medical University, Guangzhou, China.
FAU - Wang, Peng
AU  - Wang P
AD  - State Key Laboratory of Organ Failure Research, Department of Cardiology, Nanfang 
      Hospital, Southern Medical University, Guangzhou, China.
FAU - Lai, Wenyan
AU  - Lai W
AD  - State Key Laboratory of Organ Failure Research, Department of Cardiology, Nanfang 
      Hospital, Southern Medical University, Guangzhou, China.
FAU - Zeng, Qingchun
AU  - Zeng Q
AD  - State Key Laboratory of Organ Failure Research, Department of Cardiology, Nanfang 
      Hospital, Southern Medical University, Guangzhou, China.
FAU - Dong, Shaohong
AU  - Dong S
AD  - Department of Cardiology, Shenzhen People's Hospital, Shenzhen, China.
FAU - Ren, Hao
AU  - Ren H
AD  - State Key Laboratory of Organ Failure Research, Department of Cardiology, Nanfang 
      Hospital, Southern Medical University, Guangzhou, China; Department of 
      Rheumatology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
FAU - Xu, Dingli
AU  - Xu D
AD  - State Key Laboratory of Organ Failure Research, Department of Cardiology, Nanfang 
      Hospital, Southern Medical University, Guangzhou, China.
LA  - eng
PT  - Journal Article
PL  - China
TA  - Ann Palliat Med
JT  - Annals of palliative medicine
JID - 101585484
SB  - IM
MH  - Aged
MH  - Energy Metabolism
MH  - *Heart Failure
MH  - Humans
MH  - *Iron Deficiencies
MH  - Male
MH  - Middle Aged
MH  - Risk Factors
MH  - Stroke Volume
MH  - Ventricular Function, Left
OTO - NOTNLM
OT  - Iron deficiency (ID)
OT  - chronic heart failure (CHF)
OT  - ferritin
OT  - myocardial energy expenditure (MEE)
EDAT- 2022/01/13 06:00
MHDA- 2022/01/14 06:00
CRDT- 2022/01/12 01:00
PHST- 2021/07/23 00:00 [received]
PHST- 2021/12/08 00:00 [accepted]
PHST- 2022/01/12 01:00 [entrez]
PHST- 2022/01/13 06:00 [pubmed]
PHST- 2022/01/14 06:00 [medline]
AID - 10.21037/apm-21-2297 [doi]
PST - ppublish
SO  - Ann Palliat Med. 2021 Dec;10(12):12061-12071. doi: 10.21037/apm-21-2297.