{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T21:05:03Z","timestamp":1779397503489,"version":"3.53.1"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":976,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2023,3,12]],"date-time":"2023-03-12T00:00:00Z","timestamp":1678579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008334","name":"Oskar-Helene-Heim Stiftung","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008334","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008334","name":"Stiftung Oskar-Helene-Heim","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008334","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Intravenous iron therapy (IVIT) is known to improve functional status in chronic heart failure (CHF) patients. The exact mechanism is not completely understood. We correlated magnetic resonance imaging (MRI) patterns of T2* iron signal in various organs to systemic iron and exercise capacity (EC) in CHF before and after IVIT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We prospectively analysed 24 patients with systolic CHF for T2* MRI pattern of the left ventricle (LV), small and large intestines, spleen, liver, skeletal muscle, and brain for iron. In 12 patients with iron deficiency (ID), we restored iron deficit by IVIT using ferric carboxymaltose. The effects after 3 months were analysed by spiroergometry and MRI. Patients with vs. without ID showed lower blood ferritin, haemoglobin (76 \u00b1 63 vs. 196 \u00b1 82 \u03bcg\/L and 12.3 \u00b1 1.1 vs. 14.2 \u00b1 1.1 g\/dL, all P &amp;lt; 0.002), and in trend a lower transferrin saturation (TSAT) (19.1 [13.1; 28.2] vs. 25.1 [21.3; 29.1] %, P = 0.05). Spleen and liver iron was lower as expressed by higher T2* value (71.8 [66.4; 93.1] vs. 36.9 [32.9; 51.7] ms, P &amp;lt; 0.002 and 33.5 \u00b1 5.9 vs. 28.8 \u00b1 3.9 ms, and P &amp;lt; 0.03). There was a strong trend for a lower cardiac septal iron content in ID (40.6 [33.0; 57.3] vs. 33.7 [31.3; 40.2] ms, P = 0.07). After IVIT, ferritin, TSAT, and haemoglobin increased (54 [30; 104] vs. 235 [185; 339] \u03bcg\/L, 19.1 [13.1; 28.2] vs. 25.0 [21.0; 33.7] %, 12.3 \u00b1 1.1 vs. 13.3 \u00b1 1.3 g\/L, all P &amp;lt; 0.04). Peak VO2 improved (18.2 \u00b1 4.2 vs. 20.9 \u00b1 3.8 mL\/min\/kg\u22121, P = 0.05). Higher peak VO2 at anaerobic threshold was associated with higher blood ferritin, reflecting higher metabolic exercise capacity after therapy (r = 0.9, P = 0.0009). Increase in EC was associated with haemoglobin increase (r = 0.7, P = 0.034). LV iron increased by 25.4% (48.5 [36.2; 64.8] vs. 36.2 [32.9; 41.9] ms, P &amp;lt; 0.04). Spleen and liver iron increased by 46.4 and 18.2%, respectively (71.8 [66.4; 93.1] vs. 38.5 [22.4; 76.9] ms, P &amp;lt; 0.04 and 33.5 \u00b1 5.9 vs. 27.4 \u00b1 8.6 ms, P &amp;lt; 0.007). Iron in skeletal muscle, brain, intestine, and bone marrow remained unchanged (29.6 [28.6; 31.2] vs. 30.4 [29.7; 30.7] ms, P = 0.7, 81.0 \u00b1 6.3 vs. 82.9 \u00b1 9.9 ms, P = 0.6, 34.3 \u00b1 21.4 vs. 25.3 \u00b1 14.1 ms, P = 0.2, 9.4 [7.5; 21.8] vs. 10.3 [6.7; 15.7] ms, P = 0.5 and 9.8 \u00b1 1.5 vs. 13.7 \u00b1 8.9 ms, P = 0.1).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CHF patients with ID showed lower spleen, liver, and in trend lower cardiac septal iron. After IVIT, iron signal of the left ventricle as well as spleen and liver increased. Improvement in EC was associated with increase in haemoglobin after IVIT. In ID, liver, spleen, and brain but not heart iron were associated with markers of systemic ID.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.14329","type":"journal-article","created":{"date-parts":[[2023,3,12]],"date-time":"2023-03-12T22:15:00Z","timestamp":1678659300000},"page":"1847-1859","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Magnetic Resonance Imaging of Organ Iron Before and After Correction of Iron Deficiency in Patients with Heart Failure"],"prefix":"10.1093","volume":"10","author":[{"given":"Christoph","family":"Gertler","sequence":"first","affiliation":[{"name":"Department of Cardiology and Pneumology, University of G\u00f6ttingen Medical Center , G\u00f6ttingen ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner site G\u00f6ttingen , G\u00f6ttingen ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadja","family":"Jauert","sequence":"additional","affiliation":[{"name":"BIH Center for Regenerative Therapies (BCRT), Charit\u00e9 Universit\u00e4tsmedizin Berlin , Berlin ,","place":["Germany"]},{"name":"Department of Cardiology, Charit\u00e9 - Universit\u00e4tsmedizin Berlin , Berlin ,","place":["Germany"]},{"name":"DZHK (German Centre for Cardiovascular Research), partner site Berlin , Berlin ,","place":["Germany"]},{"name":"Center for Stroke Research Berlin (CSB), Charit\u00e9 - Universit\u00e4tsmedizin Berlin , Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Freyhardt","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, Helios Hospital Krefeld , Krefeld ,","place":["Germany"]},{"name":"School of Medicine, Faculty of Health, University Witten-Herdecke , Witten ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miroslava","family":"Valentova","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Pneumology, University of G\u00f6ttingen Medical Center , G\u00f6ttingen ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner site G\u00f6ttingen , G\u00f6ttingen ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven Christopher","family":"Aland","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Pneumology, University of G\u00f6ttingen Medical Center , G\u00f6ttingen ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner site G\u00f6ttingen , G\u00f6ttingen ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thula Cannon","family":"Walter-Rittel","sequence":"additional","affiliation":[{"name":"Department of Radiology, Charit\u00e9-Universit\u00e4tsmedizin Berlin , Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Unterberg-Buchwald","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Pneumology, University of G\u00f6ttingen Medical Center , G\u00f6ttingen ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner site G\u00f6ttingen , G\u00f6ttingen ,","place":["Germany"]},{"name":"Institute for Diagnostic and Interventional Radiology, University of G\u00f6ttingen Medical Center , G\u00f6ttingen ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marius","family":"Placzek","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics, University of G\u00f6ttingen , G\u00f6ttingen ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Ding-Reinelt","sequence":"additional","affiliation":[{"name":"Department of Radiology, Charit\u00e9-Universit\u00e4tsmedizin Berlin , Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarek","family":"Bekfani","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Magdeburg, Otto von Guericke-University , Magdeburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfram","family":"Doehner","sequence":"additional","affiliation":[{"name":"BIH Center for Regenerative Therapies (BCRT), Charit\u00e9 Universit\u00e4tsmedizin Berlin , Berlin ,","place":["Germany"]},{"name":"Department of Cardiology, Charit\u00e9 - Universit\u00e4tsmedizin Berlin , Berlin ,","place":["Germany"]},{"name":"DZHK (German Centre for Cardiovascular Research), partner site Berlin , Berlin ,","place":["Germany"]},{"name":"Center for Stroke Research Berlin (CSB), Charit\u00e9 - Universit\u00e4tsmedizin Berlin , Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerd","family":"Hasenfu\u00df","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Pneumology, University of G\u00f6ttingen Medical Center , G\u00f6ttingen ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner site G\u00f6ttingen , G\u00f6ttingen ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernd","family":"Hamm","sequence":"additional","affiliation":[{"name":"Department of Radiology, Charit\u00e9-Universit\u00e4tsmedizin Berlin , Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anja","family":"Sandek","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Pneumology, University of G\u00f6ttingen Medical Center , G\u00f6ttingen ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner site G\u00f6ttingen , G\u00f6ttingen ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,3,12]]},"reference":[{"key":"2026012114104734900_ehf214329-bib-0001","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1007\/s00392-018-1344-x","article-title":"Iron deficiency in patients with heart failure with preserved ejection fraction and its association with reduced exercise capacity, muscle strength and quality of life","volume":"108","author":"Bekfani","year":"2019","journal-title":"Clin Res Cardiol"},{"key":"2026012114104734900_ehf214329-bib-0002","doi-asserted-by":"crossref","first-page":"1872","DOI":"10.1093\/eurheartj\/ehq158","article-title":"Iron deficiency: an ominous sign in patients with systolic chronic heart failure","volume":"31","author":"Jankowska","year":"2010","journal-title":"Eur Heart J"},{"key":"2026012114104734900_ehf214329-bib-0003","doi-asserted-by":"crossref","first-page":"2436","DOI":"10.1056\/NEJMoa0908355","article-title":"Ferric carboxymaltose in patients with heart failure and iron deficiency","volume":"361","author":"Anker","year":"2009","journal-title":"N Engl J Med"},{"key":"2026012114104734900_ehf214329-bib-0004","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1093\/eurheartj\/ehu385","article-title":"Beneficial effects of long-term intravenous iron therapy with ferric carboxymaltose in patients with symptomatic heart failure and iron deficiency","volume":"36","author":"Ponikowski","year":"2015","journal-title":"Eur Heart J"},{"key":"2026012114104734900_ehf214329-bib-0005","doi-asserted-by":"crossref","first-page":"1895","DOI":"10.1016\/S0140-6736(20)32339-4","article-title":"Ferric carboxymaltose for iron deficiency at discharge after acute heart failure: a multicentre, double-blind, randomised, controlled trial","volume":"396","author":"Ponikowski","year":"2020","journal-title":"Lancet"},{"key":"2026012114104734900_ehf214329-bib-0006","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.119.014254","article-title":"Noninvasive imaging estimation of myocardial iron repletion following administration of intravenous iron: the myocardial-IRON trial","volume":"9","author":"N\u00fa\u00f1ez","year":"2020","journal-title":"J Am Heart Assoc"},{"key":"2026012114104734900_ehf214329-bib-0007","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1093\/eurheartj\/ehi204","article-title":"The task force for the diagnosis and treatment of chronic heart failure of the European Society of Cardiology. 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