Relationship between iron deficiency and expression of genes involved in iron metabolism in human myocardium and skeletal muscle

Cabrera, Carin Corovic; Frisk, Christoffer; Löfström, Ulrika; Lyngå, Patrik; Linde, Cecilia; Hage, Camilla; Persson, Hans; Eriksson, Maria; Wallén, Håkan; Persson, Bengt; Ekström, Mattias

doi:10.1016/j.ijcard.2023.03.032

Cited by 6 publications

(2 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…58,[111][112][113] Clinically, patients with iron deficiency have increased cardiac TfR1 expression and impaired cardiac energetics. 114,115 Yet, independently of systemic iron, failing hearts have decreased myocardial iron content and reduced mitochondrial activity, as well as decreased hepcidin, increased ferroportin and decreased sTfR 110,116,117 ; the latter findings suggests diminished entry into and enhanced egress of iron from cardiomyocytes. Furthermore, experimental chronic sympathetic stimulation causes intracellular iron deficiency and mitochondrial dysfunction in cardiomyocytes, 118 and increased plasma norepinephrine is associated with cardiac iron depletion, low sTfR and low TSAT in patients with heart failure.…”

Section: Search For Useful Diagnostic Criteria For Iron Deficiency In...mentioning

confidence: 99%

Critical re‐evaluation of the identification of iron deficiency states and effective iron repletion strategies in patients with chronic heart failure

Packer,

Anker,

Butler

et al. 2024

European J of Heart Fail

View full text Add to dashboard Cite

According to current guidelines, iron deficiency is defined by a serum ferritin level <100 ng/ml or a transferrin saturation (TSAT) <20% if the serum ferritin level is 100–299 μg/L. These criteria were developed to encourage the use of intravenous iron as an adjunct to erythropoiesis‐stimulating agents in the treatment of renal anaemia. However, in patients with heart failure, these criteria are not supported by any pathophysiological or clinical evidence that they identify an absolute or functional iron deficiency state. A low baseline TSAT—but not serum ferritin level—appears to be a reliable indicator of the effect of intravenous iron to reduce major heart failure events. In randomized controlled trials, intravenous iron decreased the risk of cardiovascular death or total heart failure hospitalization in patients with a TSAT <20% (risk ratio 0.67 [0.49–0.92]) but not in patients with a TSAT ≥20% (risk ratio 0.99 [0.74–1.30]), with the magnitude of the risk reduction being proportional to the severity of hypoferraemia. Patients who were enrolled in clinical trials solely because they had a serum ferritin level <100 μg/L showed no significant benefit on heart failure outcomes, and it is noteworthy that serum ferritin levels of 20–300 μg/L lie entirely within the range of normal values for healthy adults. Current guidelines reflect the eligibility criteria of clinical trials, which inadvertently adopted unvalidated criteria to define iron deficiency. Reliance on these guidelines would lead to the treatment of many patients who are not iron deficient (serum ferritin level <100 μg/L but normal TSAT) and ignores the possibility of iron deficiency in patients with a low TSAT but with serum ferritin level of >300 μg/L. Importantly, analyses of benefit based on trial eligibility‐driven guidelines substantially underestimate the magnitude of heart‐failure‐event risk reduction with intravenous iron in patients who are truly iron deficient. Based on all available data, we recommend a new mechanism‐based and trial‐tested approach that reflects the totality of evidence more faithfully than the historical process adopted by clinical investigators and by the guidelines. Until additional evidence is forthcoming, an iron deficiency state in patients with heart failure should be defined by a TSAT <20% (as long as the serum ferritin level is <400 μg/L), and furthermore, the use of a serum ferritin level <100 μg/L alone as a diagnostic criterion should be discarded.

show abstract

Section: Search For Useful Diagnostic Criteria For Iron Deficiency In...mentioning

confidence: 99%

Critical re‐evaluation of the identification of iron deficiency states and effective iron repletion strategies in patients with chronic heart failure

Packer,

Anker,

Butler

et al. 2024

European J of Heart Fail

View full text Add to dashboard Cite

show abstract

“…Approximately one in four individuals suffer from ID ( 2 ). Cabrera et al conducted a study using biopsies of intercostal muscles and ventricular myocardium from 69 individuals (28% diagnosed with ID), revealing significantly higher levels of TfR1 expression in the myocardium and skeletal muscles in the presence of ID ( 3 ). This suggests that IAV could potentially spread more rapidly within the myocardium of individuals with ID.…”

mentioning

confidence: 99%

Could iron deficiency potentiate the appearance of complications in Influenza A virus infection?

Cirovic,

Cirovic

2023

Proc. Natl. Acad. Sci. U.S.A.

View full text Add to dashboard Cite

Letter to the editor for the “relationship between iron deficiency and expression of genes involved in iron metabolism in human myocardium and skeletal muscle”

Ćirović¹,

Ćirović²

2023

International Journal of Cardiology

View full text Add to dashboard Cite

Relationship between iron deficiency and expression of genes involved in iron metabolism in human myocardium and skeletal muscle

Cited by 6 publications

References 29 publications

Critical re‐evaluation of the identification of iron deficiency states and effective iron repletion strategies in patients with chronic heart failure

Critical re‐evaluation of the identification of iron deficiency states and effective iron repletion strategies in patients with chronic heart failure

Could iron deficiency potentiate the appearance of complications in Influenza A virus infection?

Letter to the editor for the “relationship between iron deficiency and expression of genes involved in iron metabolism in human myocardium and skeletal muscle”

Contact Info

Product

Resources

About