241 Iron deficiency in non-anemic heart failure patients

Background Functional improvement has recently been reported in anemic and non-anemic heart failure (HF) patients with biological iron deficiency who were treated by intravenous iron substitution. Our aim was to show whether the non-anemic patients with iron deficiency have poorer functional tests than non-deficient ones. Method We included 138 HF patients without anemia from our HF department at Toulouse University Hospital into 2 groups: 1/low ferritin rate group (LFG) with a serum ferritin of 100 μg/L and lower (n = 42), 2/normal ferritin rate group (NFG) with serum ferritin over 100 μg/L (n = 96). We measured standard blood tests and functional parameters including NYHA status, 6 minute walk test (6’WT), and peak oxygen consumption (VO2 max). Results Baseline patient characteristics showed a slight difference for hemoglobin in non-anemic patients (LFG, 13.9; NFG, 14.4; p = 0.04) who have no difference for ejection fraction (LFG, 27.5%; NFG 29.5%; p = NS) between groups. The iron deficient patients tend to be older (59 versus 63 yo, p = NS) and most of them were women (92% in LFG versus 67% in NFG (p Functional parameters showed i) NYHA status of 2.29 in LFG versus 2.35 in NFG (p = NS); ii) 6’WT of 307 m in LFG versus 361 m in NFG (p = 0.006); and, iii) VO2 max of 13.8 ml/min/kg in LFG versus 15.7 ml/min/kg for the NFG (p = 0.04). Moreover, the LFG had a higher creatinin rate of 145 μmol/l versus 107 μmol/l for the NFG (p = 0.02). Conclusion Iron deficient patients have poorer functional tests and are more likely to have renal insufficiency. Risk factors for iron deficiency in HF are the age and the female sex. We put in light some risk factors for iron deficiency that may help the practitioner making out which non-anemic HF patients should have blood tests to look for iron deficiency.