Accurate Noninvasive Assessment of Myocardial Iron Load in Advanced Heart Failure Patients. (9th November 2020)

• Record Type: Journal Article
• Authors: Leszek, Przemysław; Sochanowicz, Barbara; Brzóska, Kamil; Kraj, Leszek; Kuśmierczyk, Mariusz; Śmigielski, Witold; Rywik, Tomasz M.; Sobieszczańska-Małek, Małgorzata; Rozentryt, Piotr; Kruszewski, Marcin
• Other Names: Bielecka-Dabrowa Agata Academic Editor.
• Is Part Of: Disease markers. Volume 2020(2020)
• Publication Date: 2020-11-09
• Subjects: Diagnosis -- Periodicals; Biochemical markers -- Periodicals; Pathology -- Periodicals; 616
• DOI: 10.1155/2020/8885189
• Languages: English
• ISSNs: 0278-0240

Abstract

Abstract : Background . Heart failure patients presenting with iron deficiency can benefit from systemic iron supplementation; however, there is the potential for iron overload to occur, which can seriously damage the heart. Therefore, myocardial iron (M-Iron) content should be precisely balanced, especially in already failing hearts. Unfortunately, the assessment of M-Iron via repeated heart biopsies or magnetic resonance imaging is unrealistic, and alternative serum markers must be found. This study is aimed at assessing M-Iron in patients with advanced heart failure (HF) and its association with a range of serum markers of iron metabolism. Methods . Left ventricle (LV) myocardial biopsies and serum samples were collected from 33 consecutive HF patients (25 males) with LV dysfunction (LV ejection fraction 22 (11) %; NT-proBNP 5464 (3308) pg/ml) during heart transplantation. Myocardial ferritin (M-FR) and soluble transferrin receptor (M-sTfR1) were assessed by ELISA, and M-Iron was determined by Instrumental Neutron Activation Analysis in LV biopsies. Nonfailing hearts (n = 11 ) were used as control/reference tissue. Concentrations of serum iron-related proteins (FR and sTfR1) were assessed. Results . LV M-Iron load was reduced in all HF patients and negatively associated with M-FR (r = − 0.37, p = 0.05 ). Of the serum markers, sTfR1/logFR correlated with (r = − 0.42 ; p = 0.04 ) and predicted (in a step-wise analysis, R 2 = 0.18 ; p = 0.04 ) LV M-Iron. LV M-Iron load ( μ g/g) can be calculated using the following formula: 210.24 – 22.869 × sTfR 1 / logFR . Conclusions . The sTfR1/logFR ratio can be used to predict LV M-Iron levels. Therefore, serum FR and sTfR1 levels could be used to indirectly assess LV M-Iron, thereby increasing the safety of iron repletion therapy in HF patients.