Iron deficiency predicts impaired exercise capacity in patients with systolic chronic heart failure

Ewa A. Jankowska, Piotr Rozentryt, Agnieszka Witkowska, Jolanta Nowak, Oliver Hartmann, Beata Ponikowska, Ludmila Borodulin-Nadzieja, Stephan Von Haehling, Wolfram Doehner, Waldemar Banasiak, Lech Polonski, Gerasimos Filippatos, Stefan D. Anker, Piotr Ponikowski

Research output: Contribution to journalArticlepeer-review


Background: Iron is an indispensable element of hemoglobin, myoglobin, and cytochromes, and, beyond erythropoiesis, is involved in oxidative metabolism and cellular energetics. Hence, iron deficiency (ID) is anticipated to limit exercise capacity. We investigated whether ID predicted exercise intolerance in patients with systolic chronic heart failure (CHF). Methods and Results: We prospectively studied 443 patients with stable systolic CHF (age 54 ± 10 years, males 90%, ejection fraction 26 ± 7%, New York Heart Association Class I/II/III/IV 49/188/180/26). ID was defined as: serum ferritin 2) and ventilatory response to exercise (VE-VCO 2 slope). ID was present in 35 ± 4% (±95% confidence interval) of patients with systolic CHF. Those with ID had reduced peak VO 2 and increased VE-VCO 2 slope as compared to subjects without ID (peak VO 2: 13.3 ± 4.0 versus 15.3 ± 4.5 mL•min•kg, VE-VCO 2 slope: 50.9 ± 15.8 versus 43.1 ± 11.1, respectively, both P 2 (β = -0.14, P 2 slope (β = 0.14, P 2 and VE-VCO 2 slope (P

Original languageEnglish
Pages (from-to)899-906
Number of pages8
JournalJournal of Cardiac Failure
Issue number11
Publication statusPublished - Nov 2011


  • anemia
  • Chronic heart failure
  • exercise intolerance
  • iron deficiency

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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