Heart failure & cardiomyopathies
Magnetic Resonance Imaging of Organ Iron Before and After Correction of Iron Deficiency in Patients with Heart Failure
Authors' conclusion
CHF patients with ID showed lower spleen, liver, and in trend lower cardiac septal iron. After IVIT, iron signal of the left ventricle as well as spleen and liver increased. Improvement in EC was associated with increase in haemoglobin after IVIT.
Study context
- Population
- Patients with systolic chronic heart failure (CHF)
- Participants
- 24 patients
- Exposure
- CHF with iron deficiency (ID) vs without ID; before vs after intravenous iron therapy (IVIT)
- IDn = 12
- Outcome
- T2* magnetic resonance imaging (MRI) iron signal in LV, intestines, spleen, liver, skeletal muscle and brain, correlated to systemic iron and exercise capacity
- Follow-up
- 3 months after IVIT
Methodological detailsbefore-after IVIT
- Before-after IVIT
Main finding
As reported in the abstract
Organ iron by T2* MRI (higher T2* = lower iron), ID vs without ID · before IVIT
- ID vs Without ID: P < 0.002
- ID vs Without ID: P < 0.03
- Spleen and liver iron lower in ID
Observational data: associations, not effects.
Further findings
| Outcome | ID | Without ID |
|---|---|---|
| Systemic iron markers, ID vs without ID | ||
| Ferritin | 76 ± 63 μg/L | 196 ± 82 μg/L |
| Haemoglobin | 12.3 ± 1.1 g/dL | 14.2 ± 1.1 g/dL |
| TSAT | 19.1 [13.1; 28.2] % | 25.1 [21.3; 29.1] % |
- Systemic iron markers, ID vs without ID: ferritin, haemoglobin all P < 0.002
- Systemic iron markers, ID vs without ID: Transferrin saturation (TSAT) P = 0.05
Before vs after IVIT (ID): ferritin, TSAT, haemoglobin, peak VO2 · 3 months
- Ferritin before vs after
- 54 [30; 104] vs. 235 [185; 339] μg/L
- TSAT before vs after
- 19.1 [13.1; 28.2] vs. 25.0 [21.0; 33.7] %
- Haemoglobin before vs after
- 12.3 ± 1.1 vs. 13.3 ± 1.3 g/L
- Ferritin, TSAT, haemoglobin
- all P < 0.04
- Peak VO2 before vs after
- 18.2 ± 4.2 vs. 20.9 ± 3.8 mL/min/kg-1 , P = 0.05
- Peak VO2 at anaerobic threshold vs ferritin
- r = 0.9, P = 0.0009
- Exercise capacity (EC) increase vs haemoglobin increase
- r = 0.7, P = 0.034
Organ T2* before vs after IVIT (ID) · 3 months
- Left ventricle (LV) iron increased by 25.4%
- 48.5 [36.2; 64.8] vs. 36.2 [32.9; 41.9] ms, P < 0.04
- Spleen iron increased by 46.4%
- 71.8 [66.4; 93.1] vs. 38.5 [22.4; 76.9] ms, P < 0.04
- Liver iron increased by 18.2%
- 33.5 ± 5.9 vs. 27.4 ± 8.6 ms, P < 0.007
- Skeletal muscle, brain, intestine, bone marrow iron unchanged
- 29.6 [28.6; 31.2] vs. 30.4 [29.7; 30.7] ms, P = 0.7, 81.0 ± 6.3 vs. 82.9 ± 9.9 ms, P = 0.6, 34.3 ± 21.4 vs. 25.3 ± 14.1 ms, P = 0.2, 9.4 [7.5; 21.8] vs. 10.3 [6.7; 15.7] ms, P = 0.5 and 9.8 ± 1.5 vs. 13.7 ± 8.9 ms, P = 0.1
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Magnetic Resonance Imaging of Organ Iron Before and After Correction of Iron Deficiency in Patients with Heart Failure. ESC Heart Fail. Published 12 March 2023. doi:10.
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