Iron Deficiency in Heart Failure: Mechanisms and Pathophysiology.
Iron Deficiency in Heart Failure: Mechanisms and Pathophysiology.
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DOI：
10.3390/jcm11010125
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发表时间：
2021-12-27
影响因子：
3.9
通讯作者：
Grote Beverborg N
中科院分区：
文献类型：
--
作者：
Alnuwaysir RIS;Hoes MF;van Veldhuisen DJ;van der Meer P;Grote Beverborg N
铁是一种必需的微量营养素，用于红细胞生成以外的体内无数生理过程。铁缺乏（ID）是心力衰竭（HF）患者的常见合并症，即使在非贫血患者中，患病率也高达59%。ID损害运动能力，降低生活质量，增加住院率和死亡风险，无论是否贫血。腔内矫正ID已成为HF的一种有前景的治疗方法，因为它已被证明可以缓解症状，改善生活质量和运动能力，并减少住院治疗。然而，HF中ID的病理生理学特征仍然很差。在HF中识别ID引发了更多的研究，旨在解释纠正ID如何改善HF状态以及ID的根本原因。在过去的几年中，通过表征铁调节激素hepcidin的作用，ID对骨骼肌和心肌细胞，肾脏和免疫系统的影响，在理解铁稳态方面取得了重大进展。在这篇综述中，我们总结了目前的知识和最新进展的病理生理学的ID在心力衰竭，有害的系统和细胞的后果ID。
Iron is an essential micronutrient for a myriad of physiological processes in the body beyond erythropoiesis. Iron deficiency (ID) is a common comorbidity in patients with heart failure (HF), with a prevalence reaching up to 59% even in non-anaemic patients. ID impairs exercise capacity, reduces the quality of life, increases hospitalisation rate and mortality risk regardless of anaemia. Intravenously correcting ID has emerged as a promising treatment in HF as it has been shown to alleviate symptoms, improve quality of life and exercise capacity and reduce hospitalisations. However, the pathophysiology of ID in HF remains poorly characterised. Recognition of ID in HF triggered more research with the aim to explain how correcting ID improves HF status as well as the underlying causes of ID in the first place. In the past few years, significant progress has been made in understanding iron homeostasis by characterising the role of the iron-regulating hormone hepcidin, the effects of ID on skeletal and cardiac myocytes, kidneys and the immune system. In this review, we summarise the current knowledge and recent advances in the pathophysiology of ID in heart failure, the deleterious systemic and cellular consequences of ID.
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