Intravenous iron therapy in heart failure: a different perspective

Ghafourian, Kambiz; Chang, Hsiang Chun; Ardehali, Hossein

doi:10.1002/ejhf.1434

Cited by 14 publications

(13 citation statements)

References 71 publications

(90 reference statements)

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“…Nevertheless, this approach cannot be directly applied to cancer patients as cancer growth itself directly depends on iron supply 139 . Moreover, it has been shown that chemotherapy-induced cardiotoxicity partly depends on excessive accumulation and altered compartmentalization of iron in the heart 140,141 leading to mitochondrial iron overload and dysfunction.…”

Section: Box 3 P38mentioning

confidence: 99%

Understanding the common mechanisms of heart and skeletal muscle wasting in cancer cachexia

et al. 2021

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Cachexia is a severe complication of cancer that adversely affects the course of the disease, with currently no effective treatments. It is characterized by a progressive atrophy of skeletal muscle and adipose tissue, resulting in weight loss, a reduced quality of life, and a shortened life expectancy. Although the cachectic condition primarily affects the skeletal muscle, a tissue that accounts for ~40% of total body weight, cachexia is considered a multi-organ disease that involves different tissues and organs, among which the cardiac muscle stands out for its relevance. Patients with cancer often experience severe cardiac abnormalities and manifest symptoms that are indicative of chronic heart failure, including fatigue, shortness of breath, and impaired exercise tolerance. Furthermore, cardiovascular complications are among the major causes of death in cancer patients who experienced cachexia. The lack of effective treatments for cancer cachexia underscores the need to improve our understanding of the underlying mechanisms. Increasing evidence links the wasting of the cardiac and skeletal muscles to metabolic alterations, primarily increased energy expenditure, and to increased proteolysis, ensuing from activation of the major proteolytic machineries of the cell, including ubiquitin-dependent proteolysis and autophagy. This review aims at providing an overview of the key mechanisms of cancer cachexia, with a major focus on those that are shared by the skeletal and cardiac muscles.

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Section: Box 3 P38mentioning

confidence: 99%

Understanding the common mechanisms of heart and skeletal muscle wasting in cancer cachexia

et al. 2021

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“…Treatment with ferric carboxymaltose (FCM) has consistently been shown to improve surrogates of functional capacity and quality of life in patients with HF and reduced ejection fraction 4–6 . However, the mechanisms underlying such benefits remain controversial 7,8 . Different in vitro studies showed detrimental effects of ID on mitochondrial function among myoblasts and cardiomyocytes 9,10 .…”

Section: Introductionmentioning

confidence: 99%

Short‐term changes in left and right systolic function following ferric carboxymaltose: a substudy of the Myocardial‐IRON trial

et al. 2020

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Aims The mechanisms underlying the beneficial effect of ferric carboxymaltose (FCM) in patients with heart failure (HF) and iron deficiency (ID) have not been completely characterized. The Myocardial-IRON trial was a double-blind, randomized trial that evaluated myocardial iron repletion following FCM vs. placebo in 53 patients with HF and ID. In this post hoc analysis, we evaluated whether treatment with FCM was associated with cardiac magnetic resonance changes in left and right ventricular function (LVEF and RVEF, respectively) at different points of systolic dysfunction. Methods and results We included patients from the Myocardial-IRON trial with left and right ventricular systolic dysfunction (LVSD and RVSD, respectively) at enrolment. Linear mixed regression models were used to evaluate changes at 7 and 30 days on LVEF and RVEF at cardiac magnetic resonance. At enrolment, 27 (50.9%) and 38 (71.7%) patients had LVEF < 40% (LVSD 1) or <45% (LVSD 2), respectively, and 10 (18.9%) and 17 (32.1%) patients had RVEF < 45% (RVSD 1) or <51% in women and <52% in men (RVSD 2) , respectively. Treatment with FCM was associated with a significant improvement in LVEF at 30 days (LVSD 1 : Δ2.3%, P < 0.001; LVSD 2 : Δ4.1, P = 0.014). FCM was also associated with a significant and early improvement in RVEF at 7 days (RVSD 1 : Δ6.9%, P = 0.003; RVSD 2 : Δ3.2%, P = 0.003) that persisted at 30 days (RVSD 1 : Δ8.1%, P < 0.001; RVSD 2 : Δ4.7%, P < 0.001). Conclusions In patients with HF and systolic dysfunction with ID, FCM was associated with short-term improvement in LVEF and, especially, in RVEF.

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“…In their article Ghafourian et al question the 2016 European Society of Cardiology heart failure (HF) guidelines class IIa level A recommendation for considering intravenous (i.v.) ferric carboxymaltose (FCM) in symptomatic patients with HF with reduced ejection fraction (HFrEF) and with iron deficiency (ID) to alleviate HF symptoms and to improve exercise capacity and quality of life .…”

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confidence: 99%

Intravenous iron supplementation is state of the art therapy in patients with heart failure and iron deficiency

Doehner

Haehling

2019

European J of Heart Fail

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Intravenous iron therapy in heart failure: a different perspective

Cited by 14 publications

References 71 publications

Understanding the common mechanisms of heart and skeletal muscle wasting in cancer cachexia

Understanding the common mechanisms of heart and skeletal muscle wasting in cancer cachexia

Short‐term changes in left and right systolic function following ferric carboxymaltose: a substudy of the Myocardial‐IRON trial

Intravenous iron supplementation is state of the art therapy in patients with heart failure and iron deficiency

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