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

doi:10.1016/j.cardfail.2011.08.003

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

Istituto San Raffaele Pisana

Research output: Contribution to journal › Article › peer-review

Abstract

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 language	English
Pages (from-to)	899-906
Number of pages	8
Journal	Journal of Cardiac Failure
Volume	17
Issue number	11
DOIs	https://doi.org/10.1016/j.cardfail.2011.08.003
Publication status	Published - Nov 2011

Keywords

anemia
Chronic heart failure
exercise intolerance
iron deficiency

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

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10.1016/j.cardfail.2011.08.003

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Jankowska, E. A., Rozentryt, P., Witkowska, A., Nowak, J., Hartmann, O., Ponikowska, B., Borodulin-Nadzieja, L., Von Haehling, S., Doehner, W., Banasiak, W., Polonski, L., Filippatos, G., Anker, S. D., & Ponikowski, P. (2011). Iron deficiency predicts impaired exercise capacity in patients with systolic chronic heart failure. Journal of Cardiac Failure, 17(11), 899-906. https://doi.org/10.1016/j.cardfail.2011.08.003

Iron deficiency predicts impaired exercise capacity in patients with systolic chronic heart failure. / Jankowska, Ewa A.; Rozentryt, Piotr; Witkowska, Agnieszka; Nowak, Jolanta; Hartmann, Oliver; Ponikowska, Beata; Borodulin-Nadzieja, Ludmila; Von Haehling, Stephan; Doehner, Wolfram; Banasiak, Waldemar; Polonski, Lech; Filippatos, Gerasimos; Anker, Stefan D.; Ponikowski, Piotr.

In: Journal of Cardiac Failure, Vol. 17, No. 11, 11.2011, p. 899-906.

Research output: Contribution to journal › Article › peer-review

Jankowska, EA, Rozentryt, P, Witkowska, A, Nowak, J, Hartmann, O, Ponikowska, B, Borodulin-Nadzieja, L, Von Haehling, S, Doehner, W, Banasiak, W, Polonski, L, Filippatos, G, Anker, SD & Ponikowski, P 2011, 'Iron deficiency predicts impaired exercise capacity in patients with systolic chronic heart failure', Journal of Cardiac Failure, vol. 17, no. 11, pp. 899-906. https://doi.org/10.1016/j.cardfail.2011.08.003

Jankowska, Ewa A. ; Rozentryt, Piotr ; Witkowska, Agnieszka ; Nowak, Jolanta ; Hartmann, Oliver ; Ponikowska, Beata ; Borodulin-Nadzieja, Ludmila ; Von Haehling, Stephan ; Doehner, Wolfram ; Banasiak, Waldemar ; Polonski, Lech ; Filippatos, Gerasimos ; Anker, Stefan D. ; Ponikowski, Piotr. / Iron deficiency predicts impaired exercise capacity in patients with systolic chronic heart failure. In: Journal of Cardiac Failure. 2011 ; Vol. 17, No. 11. pp. 899-906.

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abstract = "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 ",

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AU - Rozentryt, Piotr

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AU - Nowak, Jolanta

AU - Hartmann, Oliver

AU - Ponikowska, Beata

AU - Borodulin-Nadzieja, Ludmila

AU - Von Haehling, Stephan

AU - Doehner, Wolfram

AU - Banasiak, Waldemar

AU - Polonski, Lech

AU - Filippatos, Gerasimos

AU - Anker, Stefan D.

AU - Ponikowski, Piotr

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

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