Author + information
- Received October 22, 2017
- Revision received December 18, 2017
- Accepted December 19, 2017
- Published online February 12, 2018.
- aHospital Amadora-Sintra, Lisbon, Portugal
- bDepartment of Internal Medicine, Hospital Santa Maria/CHLN, Lisbon, Portugal
- cFaculty of Medicine, University of Lisbon, Lisbon, Portugal
- ↵∗Address for correspondence:
Prof. Luiz F. Menezes Falcão, Hospital Santa Maria/CHLN, Lisbon, and the Faculty of Medicine, University of Lisbon, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal.
Heart failure (HF) is highlighted by its burdening symptom-limited exercise capacity and recurrent hospitalizations. Despite substantial advances regarding disease-modifying drugs in HF with reduced ejection fraction, additional therapeutic strategies to improve quality of life are invaluable. Currently, iron deficiency (ID) is overwhelmingly recognized in over 30% to 50% of patients with stable chronic HF, which worsens prognosis. The established pathophysiological mechanisms of progressive HF may be intertwined with increasing myocardial iron scarcity, wherein one begets the other. Most importantly, ID constitutes a novel target for symptom relief in carefully selected patients. In this regard, intravenous iron may be a safe and efficacious intervention, potentially reducing HF hospitalizations. We discuss the evidence and gaps in knowledge concerning iron therapy in HF and propose a practical, comprehensive, clinically oriented algorithm for timely adequate iron replenishment in different clinical scenarios. Finally, we further debate imperative decision-making before intervention and the drawbacks of such a strategy.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received October 22, 2017.
- Revision received December 18, 2017.
- Accepted December 19, 2017.
- 2018 American College of Cardiology Foundation
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