Deficiência de Ferro na Insuficiência Cardíaca com Fração de Ejeção Reduzida: Fisiopatologia, Diagnóstico e Tratamento

Pereira, Guilherme Augusto Reissig; Beck-da-Silva, Luís

doi:10.36660/abc.20201257

Cited by 3 publications

(2 citation statements)

References 57 publications

(142 reference statements)

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“…World Journal of Cardiovascular Diseases Patients with HF may present pre-existing absolute anemia due to blood loss, unbalanced diet, use of anticoagulants or malnutrition [54]. Iron deficiency could affect myocardiocyte metabolism through the imbalance of the production of ATP, leading by itself to cell energetic and mitochondrial imbalance with impairment of ventricular performance and HF with reduced ejection fraction (HFrEF) [56] [62]. Indeed, according to the "iron hypothesis", iron deficiency can itself trigger HF leading to myocardial and mitochondria energetic failure in HFrEF [56] [61] [62] (Figure 1).…”

Section: Manlov Et Al Observed a Key Role Of Iron In Pathophysiology ...mentioning

confidence: 99%

Iron and Heart Failure: Current Concepts and Emerging Pharmacological Paradigms

Pascale,

Rondinelli,

Ascione

et al. 2024

WJCD

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Background: Emerging evidence has recognized that anemia and iron deficiency are recurrent comorbidities in chronic heart failure (HF) and several trials have established that iron administration improves myocardial asset and clinical scenario in HF. Purpose: Recent acquisitions suggest that iron deficiency represents a concrete bias in the pathogenetic mechanism of chronic HF, so we have investigated the putative role of the hepcidin/ferroportin axis in the cardiovascular setting to advocate novel pharmacological and clinical approaches. Methods: Here, after an excursus on iron metabolism, we first reviewed the ongoing studies on novel iron targeted compounds. Then, we summarize large clinical interventional studies conducted on patient suffering from iron deficiency and HF which have tested the effects of drugging iron regard QoL, hospitalizations and cardiovascular death. Results: Novel compounds such as hepcidin agonist (PTG 300), synthetic human hepcidin (LJPC-401) and anti FPN (Vamifeport) are ongoing in iron overloaded patients, while the hepcidin blocker (PRS-080) is under investigation in anemic patients. Noteworthy, novel insights could arise from the results of a Phase IV interventional study regarding the modification of hepcidin pathway in a large cohort of HF patients (n = 1992) by sodium glucose cotransporter 2 inhibitors. To date, several studies highlight the beneficial effect of iron administration in cardiovascular setting and latest evidences consider hepcidin level as a novel biomarker of cardiac injury and atherosclerosis. Conclusions: We advocate that data from ongoing studies will suggest novel iron targeted

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Section: Manlov Et Al Observed a Key Role Of Iron In Pathophysiology ...mentioning

confidence: 99%

Iron and Heart Failure: Current Concepts and Emerging Pharmacological Paradigms

Pascale,

Rondinelli,

Ascione

et al. 2024

WJCD

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“…Silva (2022) destacam a importância da deficiência de ferro na progressão da insuficiência cardíaca com fração de ejeção reduzida, demonstrando que a intervenção com ferro parenteral pode ser um método eficaz para melhorar os sintomas e a qualidade de vida dos pacientes. Este tratamento apresenta-se como uma estratégia promissora para abordar uma comorbidade frequentemente negligenciada, mas que pode ter impactos significativos na gestão clínica da doença.…”

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Avaliação do prognóstico e evolução clínica em pacientes com insuficiência cardíaca

Ferreira,

Silva,

Soares

et al. 2024

CLCS

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A insuficiência cardíaca é uma condição complexa, originada por problemas estruturais ou funcionais que impedem o coração de fornecer o fluxo sanguíneo necessário para atender às demandas do corpo. As manifestações clínicas decorrentes dessa disfunção podem limitar as atividades diárias do paciente, impactando sua qualidade de vida. Além disso, ela é responsável pela maior taxa de internações e mortalidade entre as doenças crônicas. Portanto, compreender os fatores que afetam o prognóstico dos pacientes com insuficiência cardíaca é crucial para determinar a gravidade da doença e suas consequências, facilitando o acompanhamento e o estabelecimento de tratamentos adequados. No entanto, estudos abrangentes sobre o prognóstico desses pacientes não são frequentes. Este trabalho tem como objetivo descrever os principais fatores prognósticos da insuficiência cardíaca e como determinados aspectos influenciam sua evolução a longo prazo. Realizamos uma revisão bibliográfica dos últimos cinco anos e constatamos que a caracterização da história do paciente, parâmetros clínicos, resultados de exames complementares e avaliação funcional, juntamente com a terapêutica aplicada, são elementos cruciais para determinar a qualidade de vida, taxa de internações, morbidade e mortalidade. Portanto, compreender e avaliar os aspectos prognósticos dos pacientes possibilita uma melhor monitorização e abordagem desses indivíduos.

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Integration of RNA-Seq and Machine Learning Identifies Hub Genes for Empagliflozin Benefitable Heart Failure with Reduced Ejection Fraction

Yang,

Gao,

Wang

et al. 2023

JIR

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Purpose This study aimed to analyze the hub genes of heart failure with reduced ejection fraction (HFrEF) treated with Empagliflozin using RNA sequencing (RNA-seq) and bioinformatics methods, including machine learning. Methods From February 2021 to February 2023, nine patients with HFrEF were enrolled from our hospital’s cardiovascular department. In addition to routine drug treatment, these patients received 10 mg of Empagliflozin once daily for two months. Efficacy was assessed and RNA-seq was performed on peripheral blood before and after treatment with empagliflozin. HFrEF-related hub genes were identified through bioinformatics analyses including differential gene expression analysis, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses, immune infiltration analysis, machine learning, immune cell correlation analysis and clinical indicator correlation analysis. Results The nine patients included in this study completed a two-month treatment regimen, with an average age of 62.11 ± 6.36 years. By performing bioinformatics analysis on the transcriptome from the treatment groups, 42 differentially expressed genes were identified, with six being up-regulated and 36 being down-regulated (|log2FC|>1 and adj.pvalue<0.05). Immune infiltration analysis of these genes demonstrated a significant difference in the proportion of plasma between the pre-treatment and post-treatment groups ( p <0.05). Two hub genes, GTF2IP14 and MTLN, were finally identified through machine learning. Further analysis of the correlation between the hub genes and immune cells suggested a negative correlation between GTF2IP14 and naive B cells, and a positive correlation between MTLN and regulatory T cells and resting memory CD4+ T cells ( p <0.05). Conclusion Through RNA-seq and bioinformatics analysis, this study identified GTF2IP14 and MTLN as the hub genes of HFrEF, and their mechanisms may be related to immune inflammatory responses and various immune cells.

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Deficiência de Ferro na Insuficiência Cardíaca com Fração de Ejeção Reduzida: Fisiopatologia, Diagnóstico e Tratamento

Cited by 3 publications

References 57 publications

Iron and Heart Failure: Current Concepts and Emerging Pharmacological Paradigms

Iron and Heart Failure: Current Concepts and Emerging Pharmacological Paradigms

Avaliação do prognóstico e evolução clínica em pacientes com insuficiência cardíaca

Integration of RNA-Seq and Machine Learning Identifies Hub Genes for Empagliflozin Benefitable Heart Failure with Reduced Ejection Fraction

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