Iron Deficiency in Heart Failure: Unveiling the Hidden Culprit

Abstract

Iron deficiency (ID) is a frequent comorbidity in patients with heart failure (HF). Coexistent HF and ID make the issues
more challenging to diagnose and treat. Iron deficiency exacerbates clinical symptoms, impairs quality of life and increases
the risk of recurrent hospitalization for HF. Conversely, a proinflammatory state and altered gut kinetic in HF may result
in absolute or functional ID, which conventional laboratory makers may not diagnose and differentiate accurately. Novel
diagnostic markers like soluble transferrin receptor (sTfR), reticulocyte hemoglobin concentration, red blood cell distribution
width, sTfR: log (ferritin) ratio and serum hepcidin levels may help to diagnose ID more accurately in the setting of HF. The
intravenous (IV) iron formulation has shown promising results in improving the functional class and reducing recurrent
hospitalization in patients with HF and ID. Futuristic therapies like nanosized iron preparations, hepcidin inhibitors and
hepcidin antagonists may help manage ID more efficiently and conveniently in HF. This manuscript explores the relationship
between ID and HF. It also provides the latest information related to the diagnosis and treatment of ID in HF patients