IRON DEFICIENCY IN HEART FAILURE WITH PRESERVED EJECTION FRACTION

Authors

  • Bianca Oliveira Bomfim
  • Karine Harumi de Castro Shimasaki
  • João Gabriel Garrote Vasconcelos
  • Luísa Campos Castro
  • Naiara Guimarães Barroso
  • Isabella de Oliveira e Castro
  • Francisco Magela de Oliveira Franco Filho
  • Brunna Leonel Machado
  • Laila Luiza da Silva
  • Alisson Aguiar Brito

DOI:

https://doi.org/10.63330/sasciencesv6n2-295

Keywords:

Ejection fraction, Exercise tolerance, Heart failure, Iron deficiency, Treatment

Abstract

Iron deficiency is common in heart failure and may contribute to symptoms and functional limitations even in the absence of anemia. In heart failure with preserved ejection fraction, its identification and treatment present challenges due to differences in laboratory criteria and the limited availability of clinical trials specifically addressing this population. This narrative review aimed to analyze the evidence on iron deficiency in this population, considering its diagnosis, clinical consequences, and the results of iron supplementation. Observational studies, clinical trials, and guidelines identified through online scientific sources were analyzed. The studies showed that the prevalence of iron deficiency varies according to the definition used and that its markers may be associated with symptoms and adverse outcomes. The FAIR-HFpEF trial identified an improvement in six-minute walk distance following intravenous ferric carboxymaltose, whereas the IRON-HFpEF trial showed no improvement in its main hemodynamic and metabolic parameters. Small sample sizes and differences in the outcomes assessed limit the interpretation of these results. It is concluded that assessment of iron status is relevant in heart failure with preserved ejection fraction, but the benefits of iron supplementation require confirmation in larger studies.

Downloads

Download data is not yet available.

References

BARANDIARÁN AIZPURUA, A. et al. Iron deficiency impacts prognosis but less exercise capacity in heart failure with preserved ejection fraction. ESC Heart Failure, v. 8, n. 2, p. 1304–1313, 2021. Disponível em: https://pubmed.ncbi.nlm.nih.gov/33522131/. Acesso em: 27 out. 2026.

KØBER, Lars et al. 2026 ESC guidelines for the management of heart failure. European Heart Journal, v. 47, n. 38, p. 5346–5457, 2026. Disponível em: https://pubmed.ncbi.nlm.nih.gov/42661420/. Acesso em: 27 out. 2026.

LINDBERG, Felix et al. Iron deficiency definitions in heart failure across ejection fraction phenotypes: prevalence, symptoms, and cause-specific outcomes. JACC: Heart Failure, v. 13, n. 11, 102662, 2025. Disponível em: https://pubmed.ncbi.nlm.nih.gov/41045907/. Acesso em: 27 out. 2026.

MARTENS, Pieter et al. Impact of iron deficiency on exercise capacity and outcome in heart failure with reduced, mid-range and preserved ejection fraction. Acta Cardiologica, v. 73, n. 2, p. 115–123, 2018. Disponível em: https://pubmed.ncbi.nlm.nih.gov/28730869/. Acesso em: 27 out. 2026.

MCDONAGH, Theresa A. et al. 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. European Heart Journal, v. 42, n. 36, p. 3599–3726, 2021. Disponível em: https://pubmed.ncbi.nlm.nih.gov/34447992/. Acesso em: 27 out. 2026.

VAN DE BOVENKAMP, Arno A. et al. Intravenous iron supplementation in heart failure with preserved ejection fraction and iron deficiency (IRON-HFpEF): a comprehensive phase II multicentre placebo-controlled randomised clinical trial. European Journal of Heart Failure, publicação antecipada online, 2026. Disponível em: https://pubmed.ncbi.nlm.nih.gov/42148667/. Acesso em: 27 out. 2026.

VON HAEHLING, Stephan et al. Ferric carboxymaltose and exercise capacity in heart failure with preserved ejection fraction and iron deficiency: the FAIR-HFpEF trial. European Heart Journal, v. 45, n. 37, p. 3789–3800, 2024. Disponível em: https://pubmed.ncbi.nlm.nih.gov/39185895/. Acesso em: 27 out. 2026.

Downloads

Published

2026-11-06

How to Cite

Bomfim, B. O. ., Shimasaki, K. H. de C. ., Vasconcelos, J. G. G. ., Castro, L. C. ., Barroso, N. G. ., de Oliveira e Castro, I. ., Franco Filho, F. M. de O. ., Machado, B. L. ., da Silva, L. L. ., & Brito, A. A. . (2026). IRON DEFICIENCY IN HEART FAILURE WITH PRESERVED EJECTION FRACTION . South American Sciences, 6(2), e26525. https://doi.org/10.63330/sasciencesv6n2-295

Issue

Vol. 6 No. 2 (2026): South American Sciences

Section

Artigos

License

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Autores concordam com os seguintes termos:

a) Os autores mantêm os direitos autorais e concedem à revista o direito de primeira publicação, com o trabalho simultaneamente licenciado sob a LicençaAttribution-NonCommercial-ShareAlike 4.0 International, que permite o compartilhamento do trabalho com reconhecimento da autoria e publicação inicial na Revista SAS. A licença permite o uso, a distribuição e a reprodução irrestrita, em qualquer meio, desde que devidamente citada a fonte. Essa licença permite também que outros remixem, adaptem e criem a partir do seu trabalho para fins não comerciais, desde que atribuam a você o devido crédito e que licenciem as novas criações sob termos idênticos.

b) Não cabe aos autores compensação financeira a qualquer título, por artigos ou resenhas publicados na South American Sciences.

c) Os conceitos expressos nos artigos publicados na South American Sciences são de inteira responsabilidade de seus autores.

Most read articles by the same author(s)