Iron Deficiency: Impact on Functional Capacity and Quality of Life in Heart Failure with Preserved Ejection Fraction
The effects of iron deficiency (ID) have been widely studied in heart failure (HF) with reduced ejection fraction. On the other hand, studies in HF with preserved ejection fraction (HFpEF) are few and have included small numbers of participants. The aim of this study was to assess the role that ID p...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-04-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/9/4/1199 |
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| author | Alex Alcaide-Aldeano Alberto Garay Lídia Alcoberro Santiago Jiménez-Marrero Sergi Yun Marta Tajes Elena García-Romero Carles Díez-López José González-Costello Gemma Mateus-Porta Miguel Cainzos-Achirica Cristina Enjuanes Josep Comín-Colet Pedro Moliner |
| author_facet | Alex Alcaide-Aldeano Alberto Garay Lídia Alcoberro Santiago Jiménez-Marrero Sergi Yun Marta Tajes Elena García-Romero Carles Díez-López José González-Costello Gemma Mateus-Porta Miguel Cainzos-Achirica Cristina Enjuanes Josep Comín-Colet Pedro Moliner |
| author_sort | Alex Alcaide-Aldeano |
| collection | DOAJ |
| description | The effects of iron deficiency (ID) have been widely studied in heart failure (HF) with reduced ejection fraction. On the other hand, studies in HF with preserved ejection fraction (HFpEF) are few and have included small numbers of participants. The aim of this study was to assess the role that ID plays in functional capacity and quality of life (QoL) in HFpEF while comparing several iron-related biomarkers to be used as potential predictors. ID was defined as ferritin <100 ng/mL or transferrin saturation <20%. Submaximal exercise capacity, measured by the 6-min walking test (6MWT), and QoL, assessed by the Minnesotta Living with Heart Failure Questionnaire (MLHFQ), were compared between iron deficient patients and patients with normal iron status. A total of 447 HFpEF patients were included in the present cross-sectional study, and ID prevalence was 73%. Patients with ID performed worse in the 6MWT compared to patients with normal iron status (ID 271 ± 94 m vs. non-ID 310 ± 108 m, <i>p</i> < 0.01). They also scored higher in the MLHFQ, denoting worse QoL (ID 49 ± 22 vs. non-ID 43 ± 23, <i>p</i> = 0.01). Regarding iron metabolism biomarkers, serum soluble transferrin receptor (sTfR) was the strongest independent predictor of functional capacity (β = −63, <i>p</i> < 0.0001, R<sup>2</sup> 0.39) and QoL (β = 7.95, <i>p</i> < 0.0001, R<sup>2</sup> 0.14) in multivariate models. This study postulates that ID is associated with worse functional capacity and QoL in HFpEF as well, and that sTfR is the best iron-related biomarker to predict both. Our study also suggests that the effects of ID could differ among HFpEF patients by left ventricular ejection fraction. |
| first_indexed | 2024-03-10T20:18:05Z |
| format | Article |
| id | doaj.art-2952a13593244948878531be2a332719 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T20:18:05Z |
| publishDate | 2020-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-2952a13593244948878531be2a3327192023-11-19T22:22:39ZengMDPI AGJournal of Clinical Medicine2077-03832020-04-0194119910.3390/jcm9041199Iron Deficiency: Impact on Functional Capacity and Quality of Life in Heart Failure with Preserved Ejection FractionAlex Alcaide-Aldeano0Alberto Garay1Lídia Alcoberro2Santiago Jiménez-Marrero3Sergi Yun4Marta Tajes5Elena García-Romero6Carles Díez-López7José González-Costello8Gemma Mateus-Porta9Miguel Cainzos-Achirica10Cristina Enjuanes11Josep Comín-Colet12Pedro Moliner13University of Barcelona, School of Medicine, 08036 Barcelona, SpainCommunity Heart Failure Unit, Department of Cardiology, Bellvitge University Hospital, L’Hospitalet de Llobregat, 08907 Barcelona, SpainCommunity Heart Failure Unit, Department of Cardiology, Bellvitge University Hospital, L’Hospitalet de Llobregat, 08907 Barcelona, SpainCommunity Heart Failure Unit, Department of Cardiology, Bellvitge University Hospital, L’Hospitalet de Llobregat, 08907 Barcelona, SpainCommunity Heart Failure Unit, Department of Cardiology, Bellvitge University Hospital, L’Hospitalet de Llobregat, 08907 Barcelona, SpainCommunity Heart Failure Unit, Department of Cardiology, Bellvitge University Hospital, L’Hospitalet de Llobregat, 08907 Barcelona, SpainBellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08907 Barcelona, SpainBellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08907 Barcelona, SpainUniversity of Barcelona, School of Medicine, 08036 Barcelona, SpainDepartment of Cardiology, Bellvitge University Hospital, L’Hospitalet de Llobregat, 08907 Barcelona, SpainJohns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology Johns Hopkins University School of Medicine, Baltimore, MD 21287, USACommunity Heart Failure Unit, Department of Cardiology, Bellvitge University Hospital, L’Hospitalet de Llobregat, 08907 Barcelona, SpainUniversity of Barcelona, School of Medicine, 08036 Barcelona, SpainCommunity Heart Failure Unit, Department of Cardiology, Bellvitge University Hospital, L’Hospitalet de Llobregat, 08907 Barcelona, SpainThe effects of iron deficiency (ID) have been widely studied in heart failure (HF) with reduced ejection fraction. On the other hand, studies in HF with preserved ejection fraction (HFpEF) are few and have included small numbers of participants. The aim of this study was to assess the role that ID plays in functional capacity and quality of life (QoL) in HFpEF while comparing several iron-related biomarkers to be used as potential predictors. ID was defined as ferritin <100 ng/mL or transferrin saturation <20%. Submaximal exercise capacity, measured by the 6-min walking test (6MWT), and QoL, assessed by the Minnesotta Living with Heart Failure Questionnaire (MLHFQ), were compared between iron deficient patients and patients with normal iron status. A total of 447 HFpEF patients were included in the present cross-sectional study, and ID prevalence was 73%. Patients with ID performed worse in the 6MWT compared to patients with normal iron status (ID 271 ± 94 m vs. non-ID 310 ± 108 m, <i>p</i> < 0.01). They also scored higher in the MLHFQ, denoting worse QoL (ID 49 ± 22 vs. non-ID 43 ± 23, <i>p</i> = 0.01). Regarding iron metabolism biomarkers, serum soluble transferrin receptor (sTfR) was the strongest independent predictor of functional capacity (β = −63, <i>p</i> < 0.0001, R<sup>2</sup> 0.39) and QoL (β = 7.95, <i>p</i> < 0.0001, R<sup>2</sup> 0.14) in multivariate models. This study postulates that ID is associated with worse functional capacity and QoL in HFpEF as well, and that sTfR is the best iron-related biomarker to predict both. Our study also suggests that the effects of ID could differ among HFpEF patients by left ventricular ejection fraction.https://www.mdpi.com/2077-0383/9/4/1199heart failure with preserved ejection fractionHFpEFiron deficiencyquality of lifesubmaximal exercise capacity6-min walking test |
| spellingShingle | Alex Alcaide-Aldeano Alberto Garay Lídia Alcoberro Santiago Jiménez-Marrero Sergi Yun Marta Tajes Elena García-Romero Carles Díez-López José González-Costello Gemma Mateus-Porta Miguel Cainzos-Achirica Cristina Enjuanes Josep Comín-Colet Pedro Moliner Iron Deficiency: Impact on Functional Capacity and Quality of Life in Heart Failure with Preserved Ejection Fraction Journal of Clinical Medicine heart failure with preserved ejection fraction HFpEF iron deficiency quality of life submaximal exercise capacity 6-min walking test |
| title | Iron Deficiency: Impact on Functional Capacity and Quality of Life in Heart Failure with Preserved Ejection Fraction |
| title_full | Iron Deficiency: Impact on Functional Capacity and Quality of Life in Heart Failure with Preserved Ejection Fraction |
| title_fullStr | Iron Deficiency: Impact on Functional Capacity and Quality of Life in Heart Failure with Preserved Ejection Fraction |
| title_full_unstemmed | Iron Deficiency: Impact on Functional Capacity and Quality of Life in Heart Failure with Preserved Ejection Fraction |
| title_short | Iron Deficiency: Impact on Functional Capacity and Quality of Life in Heart Failure with Preserved Ejection Fraction |
| title_sort | iron deficiency impact on functional capacity and quality of life in heart failure with preserved ejection fraction |
| topic | heart failure with preserved ejection fraction HFpEF iron deficiency quality of life submaximal exercise capacity 6-min walking test |
| url | https://www.mdpi.com/2077-0383/9/4/1199 |
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