Dr. Niels Grote Beverborg, MD PhD Post-doctoral research fellow Department of experimental cardiology University Medical Center Groningen, Groningen, The Netherlands Integrated CardioMetabolic Center Karolinska Institutet, Stockholm Sweden

Heart Failure: Low Iron Storage vs Defective Iron Utilization

MedicalResearch.com Interview with:

Dr. Niels Grote Beverborg, MD PhD Post-doctoral research fellow Department of experimental cardiology University Medical Center Groningen, Groningen, The Netherlands Integrated CardioMetabolic Center Karolinska Institutet, Stockholm Sweden

Dr. Grote Beverborg

Dr. Niels Grote Beverborg, MD PhD
Post-doctoral research fellow
Department of experimental cardiology
University Medical Center Groningen,
Groningen, The Netherlands
Integrated CardioMetabolic Center
Karolinska Institutet, Stockholm
Sweden 

MedicalResearch.com: What is the background for this study?  

Response: Iron deficiency is very prevalent worldwide and a significant cause of morbidity and mortality, especially in vulnerable populations such as patients with heart failure. It is well known that iron deficiency can be a consequence of an insufficient iron uptake or increased iron loss (termed low iron storage), or of a chronic low inflammatory state (defective iron utilization). However, so far, we had no tools to distinguish these causes from each other in patients and have not been able to assess their potential consequences.

MedicalResearch.com:? What are the main findings?

Response: Using bone marrow iron stainings, we could identify the presence of either of the two causes of iron deficiency in two thirds of patients with heart failure. A low ferritin was a strong predictor of a low iron storage. This went hand in hand with more anemia, worse quality of life and an impaired prognosis. On the other hand, inflammation related iron deficiency, defective iron utilization, was linked to an impaired physical condition but not with a worse prognosis.

MedicalResearch.com: What should readers take away from your report?

Response: Not every patient with iron deficiency is the same; the underlying cause does matter. Every patient with heart failure should be checked for the presence of iron deficiency. If present, investigations in its cause should be undertaken, starting with distinguishing a decreased iron storage from defective iron utilization. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: At this moment, patients with iron deficiency are treated with iron irrespective of the cause. Trials are ongoing to improve prognosis with iron treatment. Our results show that patients with defective iron utilization do not have an impaired prognosis, so it would be informative to specifically look at this population. After all, if iron deficiency does not impact the prognosis of these patients, trying to improve their prognosis with iron might be irrational. 

Citation: 

Differences in Clinical Profile and Outcomes of Low Iron Storage vs Defective Iron Utilization in Patients With Heart Failure Results From the DEFINE-HF and BIOSTAT-CHF Studies

https://jamanetwork.com/journals/jamacardiology/article-abstract/2735317 

Jul 11, 2019 @ 11:44 am

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