{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T19:00:47Z","timestamp":1784055647925,"version":"3.55.0"},"reference-count":35,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T00:00:00Z","timestamp":1753747200000},"content-version":"vor","delay-in-days":28,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pulm. circ."],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Iron deficiency (ID) is prevalent in pulmonary hypertension(PH), but there is no consensus on ID definition and its possible correlation to prognostic markers. Hence, in this study, PH\u2010patients were recruited at the University Hospital Zurich from May 2019 to April 2021. Clinical and hemodynamic characteristics were recorded at inclusion and venous blood samples were taken. ID was defined as: (i) ferritin\u2010ID: ferritin&lt;\u2009100\u2009\u00b5g\/L or 100\u2013299\u2009\u00b5g\/L plus a transferrin saturation (TSAT)\u2009&lt;\u200920%; (ii) TSAT\u2010ID: a TSAT\u2009&lt;\u200920% (males)\/&lt;\u200915% (females) and (iii) TFRI\u2010ID: a transferrin receptor index (TFRI)\u2009&gt;\u20093.2\/\u2009&gt;\u20092.0 depending on CRP\u2009&lt;\u2009\/\u2009&gt;\u20095\u2009mg\/L. 94 patients (52% female, mean age 62.9\u2009\u00b1\u200914.6 years) with pulmonary arterial hypertension(48%), PH associated with lung disease (20%) or chronic thromboembolic PH (32%) were included. Sixty\u2010seven percent fulfilled criteria for ferritin\u2010ID, 35% for TSAT\u2010ID, and 13% for TFRI\u2010ID. Mean pulmonary arterial pressure (mPAP) was elevated in TFRI\u2010ID patients compared to non\u2010ID (50\u2009\u00b1\u200912.2\u2009mmHg vs. 35.9\u2009\u00b1\u200911.7\u2009mmHg); however, after correction for age, sex, PH\u2010type, and anticoagulation, the difference was nonsignificant (<jats:italic>p<\/jats:italic>\u2009=\u20090.085). NT\u2010proBNP was significantly higher in TFRI\u2010ID\u2010positive (1237\u2009\u00b1\u20091166\u2009pg\/mL vs. 334\u2009\u00b1\u2009417\u2009pg\/mL, <jats:italic>p<\/jats:italic>\u2009=\u20090.004). No significant differences were found for ferritin\u2010ID and TSAT\u2010ID (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). Six\u2010minute walk distance (6MWD) was reduced for both TSAT\u2010ID (402\u2009\u00b1\u2009133\u2009m vs. 469\u2009\u00b1\u2009152\u2009m, <jats:italic>p<\/jats:italic>\u2009=\u20090.006) and TFRI\u2010ID (370\u2009\u00b1\u2009112\u2009m vs. 459\u2009\u00b1\u2009151\u2009m, <jats:italic>p<\/jats:italic>\u2009=\u20090.052), but not for ferritin\u2010ID (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). In conclusion, TFRI\u2010ID is seemingly associated with clinical markers of right heart parameters and disease severity. This could not be seen with the currently recommended ferritin\u2010ID\u2010definition or TSAT\u2010ID. More data is needed to assess the use of the TFRI\u2010ID instead of the ferritin\u2010ID\u2010definition as a method to identify PH\u2010patients at risk and as a threshold for iron substitution.<\/jats:p>","DOI":"10.1002\/pul2.70142","type":"journal-article","created":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T13:04:13Z","timestamp":1753794253000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Reassessment of the Current Iron Deficiency Definition in Pulmonary Hypertension"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1079-7637","authenticated-orcid":false,"given":"Aurelia E.","family":"Reiser","sequence":"first","affiliation":[{"name":"Institute of Veterinary Physiology, Vetsuisse Faculty University of Z\u00fcrich Zurich 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