Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.
Institute of Heart Diseases, University Hospital, Wroclaw, Poland.
Cardiol J. 2021;28(6):962-969. doi: 10.5603/CJ.a2021.0165. Epub 2021 Dec 13.
Acute heart failure (AHF) syndromes are among the most frequent causes of hospitalization in the elderly and put a heavy financial burden on healthcare systems, mainly due to high early readmission rates. The understanding of AHF has evolved over the years from a significant hemodynamic failure to a multi-organ disease in the course of which peripheral mechanisms such as dysregulated cardiorenal axis or inflammation also play essential roles. A few available observational studies investigating iron deficiency (ID) in patients hospitalized for AHF indicate that this comorbidity is more prevalent than in chronic heart failure, and iron status presents some dynamics in these subjects. ID in AHF predicts increased mortality, greater risk for early readmission and is related to prolonged hospitalization. This paper reviews the results of the first multicenter, double-blind, randomized clinical trial on ferric carboxymaltose in patients who were stabilized after an episode of AHF who had concomitant ID (AFFIRM-AHF), and potential pathophysiological links between dysregulated iron status and AHF syndromes are discussed.
急性心力衰竭（AHF）综合征是老年人住院的最常见原因之一，给医疗系统带来了沉重的经济负担，主要是由于早期再入院率较高。多年来，对 AHF 的认识已经从显著的血流动力学衰竭发展为多器官疾病，在此过程中，心脏-肾脏轴失调或炎症等外周机制也起着至关重要的作用。一些针对因 AHF 住院患者缺铁（ID）的观察性研究表明，这种合并症比慢性心力衰竭更为普遍，并且这些患者的铁状态存在一些动态变化。AHF 中的 ID 可预测死亡率增加、早期再入院风险更高，并与住院时间延长有关。本文回顾了首个关于铁羧基麦芽糖铁在 AHF 发作后稳定的患者中的多中心、双盲、随机临床试验的结果（AFFIRM-AHF），并讨论了铁状态失调与 AHF 综合征之间潜在的病理生理学联系。
