Iron Deficiency in Heart Failure: Unveiling the Hidden Culprit

Abstract

Iron deficiency (ID) is a frequent comorbidity in patients with heart failure (HF). Coexistent HF and ID make the issuesmore challenging to diagnose and treat. Iron deficiency exacerbates clinical symptoms, impairs quality of life and increasesthe risk of recurrent hospitalization for HF. Conversely, a proinflammatory state and altered gut kinetic in HF may resultin absolute or functional ID, which conventional laboratory makers may not diagnose and differentiate accurately. Noveldiagnostic markers like soluble transferrin receptor (sTfR), reticulocyte hemoglobin concentration, red blood cell distributionwidth, sTfR: log (ferritin) ratio and serum hepcidin levels may help to diagnose ID more accurately in the setting of HF. Theintravenous (IV) iron formulation has shown promising results in improving the functional class and reducing recurrenthospitalization in patients with HF and ID. Futuristic therapies like nanosized iron preparations, hepcidin inhibitors andhepcidin antagonists may help manage ID more efficiently and conveniently in HF. This manuscript explores the relationshipbetween ID and HF. It also provides the latest information related to the diagnosis and treatment of ID in HF patients