The following is a summary of “Effect of iron deficiency on RV function in acute decompensated heart failure patients,” published in the November 2023 issue of Cardiology by Engin et al.

Though iron deficiency demonstrably harms left ventricle (LV) pumping in heart failure (HF), its effect on the right ventricle’s (RV) crucial role is uncertain. Researchers conducted a retrospective study to investigate the hidden impact of iron deficiency on RV function in HF patients.

They enrolled 100 patients with acute decompensated heart failure (ADHF), irrespective of LV ejection fraction (LVEF). Correlations between iron deficiency and TAPSE, RVEF, RV FAC, and RV TDI S’ were mainly focused. Additionally, the influence of iron deficiency was explored on RV-free wall global longitudinal strain (GLS) as a secondary outcome.

The results showed a mean age of 70±10 years and a 64% male predominance. With a prevalence rate of Hypertension (HT) at 80%, diabetes mellitus (DM) at 52%, ischemic heart disease (IHD) at 71%, and chronic obstructive pulmonary disease (COPD) at 18%. The median LVEF was 35%, with 66% HFrEF, 6% HFmrEF, and 28% HFpEF. Transthoracic echocardiography indicated a median TAPSE of 16.4 mm, mean FAC of 37.2±7.8%, mean RV GLS of -16.4±5.1%, and mean RV TDI S’ of 10.6±2.9 cm/s. Iron deficiency affected 58% of patients, showing no demographic or LVEF differences. However, TAPSE (15.6 vs. 17.2 mm, P=0.05) and RV free wall GLS (-14.7% vs. -18.2%, P=0.005) were lower in HF patients with iron deficiency. Anemia was present in 56% of patients, with lower TAPSE (15.3 vs. 17.3 mm, P=0.01) and RV GLS (-14.7% vs. -18.6%, P=0.01).

They concluded that in ADHF, early iron deficiency harms the RV subtly, reducing free wall function before standard measures decline. Early detection and treatment can intercept further damage and improve outcomes.

Source: academic.oup.com/eurheartj/article/44/Supplement_2/ehad655.929/7392950?searchresult=1