Suciadi Leonardo P, Henrina Joshua, Putra Iwan Cahyo Santosa, Cahyadi Irvan, Gunawan Hoo Felicia Hadi
Cardiology, Siloam Hospitals Kebon Jeruk/Siloam Heart Institute, Jakarta, IDN.
Family Medicine, Balaraja Public Health Center, Tangerang, IDN.
Cureus. 2022 Jan 13;14(1):e21224. doi: 10.7759/cureus.21224. eCollection 2022 Jan.
Iron deficiency is prevalent in chronic heart failure (CHF) patients. Nonetheless, the diagnosis is often overlooked and, often, the treatment is commenced just when overt anemia has ensued. Therefore, a better appreciation of this disease is needed, and all seasoned cardiologists should know how to approach CHF patients with iron deficiency correctly, as mandated by clinical practice guidelines. In this comprehensive review, we describe iron homeostasis, the pathophysiologic changes of iron homeostasis, and the clinical implications of iron deficiency on CHF patients. In addition, we delineate the evolution of clinical trials, ranging from the inception to the ongoing clinical trials of iron deficiency treatment in CHF patients. Iron deficiency contributes to the worse clinical outcome of the patients. Numerous studies have reported the clinical benefit of iron supplementation, particularly in intravenous preparation, in heart failure patients regarding symptoms, functional capacity, and quality of life (QoL) improvement. Therefore, the current guidelines recommend routine screening of iron status in all newly diagnosed heart failure patients. Eventually, intravenous iron replacement is recommended for symptomatic heart failure patients with iron deficiency, irrespective of anemia.
缺铁在慢性心力衰竭（CHF）患者中很常见。尽管如此，该诊断常常被忽视，而且通常在出现明显贫血时才开始治疗。因此，需要更好地认识这种疾病，并且所有经验丰富的心脏病专家都应知道如何按照临床实践指南的要求正确处理缺铁的CHF患者。在这篇全面综述中，我们描述了铁稳态、铁稳态的病理生理变化以及缺铁对CHF患者的临床影响。此外，我们阐述了临床试验的发展历程，从CHF患者缺铁治疗的初始试验到正在进行的临床试验。缺铁会导致患者临床结局更差。许多研究报告了补充铁剂，特别是静脉制剂，对心力衰竭患者在症状、功能能力和生活质量（QoL）改善方面的临床益处。因此，当前指南建议对所有新诊断的心力衰竭患者进行铁状态的常规筛查。最终，对于有症状的缺铁心力衰竭患者，无论是否贫血，均推荐静脉补铁。
