Iron deficiency in pulmonary arterial hypertension: prevalence and potential usefulness of oral supplementation

Stefano Ghio, Federico Fortuni, Anna Clizia Capettini, Laura Scelsi, Alessandra Greco, Eleonora Vullo, Claudia Raineri, Stefania Guida, Annalisa Turco, Chiara Gargiulo, Luigi Oltrona Visconti

Research output: Contribution to journalArticlepeer-review


Background: The aim of this study was to evaluate the prevalence of iron depletion in a prevalent population of patients with pulmonary arterial hypertension (PAH) and to gain preliminary insights on the possibility of its treatment with oral drugs. Methods: Iron status was determined in 31 consecutive prevalent idiopathic patients with PAH. Iron depletion was defined as serum iron <10 mmol/L and decreased transferrin saturation irrespective of the coexistence of anaemia. Patients underwent laboratory examinations, 6-min walking test and echocardiography in the same day. A subgroup of iron depleted patients received one oral capsule/day containing 30 mg of pyrophosphate liposomal iron for 16 weeks. After this period all patients were re-evaluated. Results: Iron depletion was observed in 22 patients (71%), of whom 6 were also anaemic and 16 were not anaemic. Iron depletion was associated with higher systolic pulmonary artery pressure (60 [50–90] vs. 45 [40–50] mmHg, p =.007), greater prevalence of moderate to severe tricuspid regurgitation (36% vs. 0%, p =.039), lower tricuspid annular plane systolic excursion (23 [21–24] vs. 19 [18–20] mm; p =.025]) and higher left ventricular eccentricity index (1.35 vs. 1, p =.042). After 16 weeks of treatment, 6-min walking distance significantly improved (500 [390–500] vs. 530 [410–550] metres; p =.043). Conclusions: Iron deficiency is highly prevalent in patients with PAH and is associated with worse clinical conditions. Treatment with oral liposomal iron is a therapeutic option which should be further investigated in future trials.

Original languageEnglish
JournalActa Cardiologica
Publication statusAccepted/In press - Jan 1 2020


  • iron deficiency
  • iron supplementation
  • Pulmonary arterial hypertension

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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