Myocardial iron content and mitochondrial function in human heart failure: a direct tissue analysis

Melenovský, Vojtěch; Petrák, Jir̆ı́; Mráček, Tomáš; Beneš, Jan; Borlaug, Barry A.; Nůsková, Hana; Pluháček, Tomáš; Spaténka, J; Kovalčíková, Jana; Drahota, Z; Kautzner, Josef; Pirk, Jan; Houštěk, J

doi:10.1002/ejhf.640

Cited by 191 publications

(179 citation statements)

References 34 publications

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“…Hence, cells with high energy demands, including skeletal, vascular, and cardiac myocytes, are particularly sensitive to depleted Fe stores . Cardiac Fe‐deficiency is present in patients with heart failure and is associated with impaired mitochondrial function, abnormal sarcomere structure, and left ventricular systolic dysfunction; however, in our study, after supplying the fermented milk diets, the hematological parameters recovered, revealing that Fe deficiency was recovered and therefore most of the parameters related to CD were unaffected at the end of the EP. However, CTGF and MCP‐1 were still increased in anemic animals fed fermented cow milk either with normal‐Fe or Fe‐overload, and VEGF was also higher in anemic animals fed fermented goat or cow milk with Fe‐overload, revealing that, although hematological status was normal, Fe homeostasis and metabolism recovered better with fermented goat milk, as previously described .…”

Section: Resultsmentioning

confidence: 54%

Fermented goat milk consumption improves cardiovascular health during anemia recovery

et al. 2018

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Section: Resultsmentioning

confidence: 54%

Fermented goat milk consumption improves cardiovascular health during anemia recovery

et al. 2018

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“…This mechanism has been implicated in the role of iron deficiency in heart failure [2]. Firstly, non-anaemic iron deficiency may lead to lower starting and nadir haemoglobin, with subsequent detriment to oxygen-carrying capacity.…”

Section: Discussionmentioning

confidence: 99%

“…Although clinicians most commonly associate iron with haemoglobin and oxygen carrying capacity, iron plays important roles in the metabolism of many cell types [2]. In other patient populations, non-anaemic iron deficiency has been linked to a variety of negative health outcomes, including poorer metrics of physical and mental wellbeing [3], and exercise capacity [4].…”

Section: Introductionmentioning

confidence: 99%

Postoperative outcomes following cardiac surgery in non‐anaemic iron‐replete and iron‐deficient patients – an exploratory study

Miles

Kunz

et al. 2017

Anaesthesia

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Iron deficiency anaemia is strongly associated with poor outcomes after cardiac surgery. However, pre-operative non-anaemic iron deficiency (a probable anaemia precursor) has not been comprehensively examined in patients undergoing cardiac surgery, despite biological plausibility and evidence from other patient populations of negative effect on outcome. This exploratory retrospective cohort study aimed to compare an iron-deficient group of patients undergoing cardiac surgery with an iron-replete group. Consecutive non-anaemic patients undergoing elective coronary artery bypass grafting or single valve replacement in our institution between January 2013 and December 2015 were considered for inclusion. Data from a total of 277 patients were analysed, and were categorised by iron status and blood haemoglobin concentration into iron-deficient (n = 109) and iron-replete (n = 168) groups. Compared with the iron-replete group, patients in the iron-deficient group were more likely to be female (43% vs. 12%, iron-replete, respectively); older, mean (SD) age 64.4 (9.7) vs. 63.2 (10.3) years; and to have a higher pre-operative EuroSCORE (median IQR [range]) 3 (2-5 [0-10]) vs. 3 (2-4 [0-9]), with a lower preoperative haemoglobin of 141.6 (11.6) vs. 148.3 (11.7) g.l . Univariate analysis suggested that iron-deficient patients had a longer hospital length of stay (7 (6-9 [2-40]) vs. 7 (5-8 [4-23]) days; p = 0.013) and fewer days alive and out of hospital at postoperative day 90 (83 (80-84 [0-87]) vs. 83 (81-85 [34-86]), p = 0.009). There was no evidence of an association between iron deficiency and either lower nadir haemoglobin or higher requirement for blood products during inpatient stay. After adjusting the model for pre-operative age, sex, renal function, EuroSCORE and haemoglobin, the mean increase in hospital length of stay in the iron-deficient group relative to the iron-replete group was 0.86 days (bootstrapped 95%CI -0.37 to 2.22, p = 0.098). This exploratory study suggests there is weak evidence of an association between non-anaemic iron deficiency and outcome after cardiac surgery after controlling for potentially confounding variables.

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“…[58][59][60] Ferric carboxymaltose improves functional capacity, symptoms, and quality of life of HF patients with iron deficiency. Its deficiency may be also a cause of impaired contractility.…”

Section: Treatment Of Iron Deficiencymentioning

confidence: 99%

Highlights in heart failure

et al. 2019

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Heart failure (HF) remains a major cause of mortality, morbidity, and poor quality of life. It is an area of active research. This article is aimed to give an update on recent advances in all aspects of this syndrome. Major changes occurred in drug treatment of HF with reduced ejection fraction (HFrEF). Sacubitril/valsartan is indicated as a substitute to ACEi/ARBs after PARADIGM-HF (hazard ratio [HR], 0.80; 95% confidence interval [CI], 0.73 to 0.87 for sacubitril/valsartan vs. enalapril for the primary endpoint and Wei, Lin and Weissfeld HR 0.79, 95% CI 0.71-0.89 for recurrent events). Its initiation was then shown as safe and potentially useful in studies in patients hospitalized for acute HF. More recently, DAPA-HF trial showed the beneficial effects of the sodium-glucose transporter type 2 (SGLT2) inhibitor dapaglifozin vs. placebo, added to optimal standard therapy [HR, 0.74; 95% CI, 0.65 to 0.85;0.74; 95% CI, 0.65 to 0.85 for the primary endpoint]. Trials with other SGLT 2 inhibitors and in other patients, such as those with HF with preserved ejection fraction (HFpEF) or with recent decompensation, are ongoing. Multiple studies showed the unfavourable prognostic significance of abnormalities in serum potassium levels. Potassium lowering agents may allow initiation and titration of mineralocorticoid antagonists in a larger proportion of patients. Meta-analyses suggest better outcomes with ferric carboxymaltose in patients with iron deficiency. Drugs effective in HFrEF may be useful also in HF with mid-range ejection fraction. Better diagnosis and phenotype characterization seem warranted in HF with preserved ejection fraction. These and other burning aspects of HFpEF research are summarized and reviewed in this article.A multiparametric approach is often proposed for risk stratification of HF patients. The prognostic accuracy of the metabolic exercise test data combined with cardiac and kidney indexes risk score was found as superior to the HF Survival Score and Seattle HF model risk scores in a cohort of 6112 1106 D. Tomasoni et al.

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Myocardial iron content and mitochondrial function in human heart failure: a direct tissue analysis

Cited by 191 publications

References 34 publications

Fermented goat milk consumption improves cardiovascular health during anemia recovery

Fermented goat milk consumption improves cardiovascular health during anemia recovery

Postoperative outcomes following cardiac surgery in non‐anaemic iron‐replete and iron‐deficient patients – an exploratory study

Highlights in heart failure

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