Affiliation:
1. Centro Cardiologico Monzino, IRCCS, Via Parea 4, 20138 Milano, Italy
2. Translational Medicine PhD Course, University of Milan, Milan, Italy
3. Cardiovascular Section, Department of Clinical Science and Community Health, University of Milan, Milan, Italy
Abstract
Abstract
Aims
Impaired iron transport (IIT) occurs frequently in heart failure (HF) patients, even in the absence of anaemia and it is associated with a poor quality of life and prognosis. The impact of IIT on exercise capacity, as assessed by the cardiopulmonary exercise test (CPET), in HF is at present unknown. The aim of this article is to evaluate in HF patients the impact on exercise performance of IIT, defined as transferrin saturation (TSAT) <20%.
Methods and results
We collected data of 676 patients hospitalized for HF. All underwent laboratory analysis, cardiac ultrasound, and CPET. Patients were grouped by the presence/absence of IIT and anaemia (haemoglobin <13 and <12 g/dL in male and female, respectively): Group 1 (G1) no anaemia, no IIT; Group 2 (G2) anaemia, no IIT; Group 3 (G3) no anaemia, IIT; Group 4 (G4) anaemia and IIT. Peak oxygen uptake (peakVO2) reduced from G1 to G3 and from G2 to G4 (G1: 1266 ± 497 mL/min, G2: 1011 ± 385 mL/min, G3: 1041 ± 395 mL/min, G4: 833 ± 241 mL/min), whereas the ventilation to carbon dioxide relationship slope (VE/VCO2 slope) increased (G1: 31.8 ± 7.5, G2: 34.5 ± 7.4, G3: 36.1 ± 10.2, G4: 37.5 ± 8.4). At multivariate regression analysis, peakVO2 independent predictors were anaemia, brain natriuretic peptide (BNP), and left ventricular ejection fraction, whereas VE/VCO2 slope independent predictors were IIT and BNP.
Conclusion
In HF IIT is associated with exercise performance impairment independently from anaemia, and it is a predictor of elevated VE/VCO2 slope, a pivotal index of HF prognosis.
Publisher
Oxford University Press (OUP)
Subject
Cardiology and Cardiovascular Medicine,Epidemiology
Reference54 articles.
1. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016;GBD 2017 Disease and Injury Incidence and Prevalence Collaborators;Lancet,2017
2. Iron deficiency: an ominous sign in patients with systolic chronic heart failure;Jankowska;Eur Heart J,2010
3. High prevalence of iron deficiency in patients with acute decompensated heart failure;Cohen-Solal;Eur J Heart Fail,2014
4. Iron deficiency is a key determinant of health-related quality of life in patients with chronic heart failure regardless of anaemia status;Comín-Colet;Eur J Heart Fail,2013
5. Iron deficiency and risk of early readmission following a hospitalization for acute heart failure;Nunez;Eur J Heart Fail,2016
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