{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:50:23Z","timestamp":1787028623786,"version":"build-2736575974"},"reference-count":67,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,5,25]],"date-time":"2022-05-25T00:00:00Z","timestamp":1653436800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Vifor Pharma, Glattbrugg, Switzerland"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Iron deficiency (ID) is a comorbid condition frequently seen in patients with heart failure (HF). Iron has an important role in the transport of oxygen, and is also essential for skeletal and cardiac muscle, which depend on iron for oxygen storage and cellular energy production. Thus, ID per se, even without anaemia, can be harmful. In patients with HF, ID is associated with a poorer quality of life (QoL) and exercise capacity, and a higher risk of hospitalisations and mortality, even in the absence of anaemia. Despite its negative clinical consequences, ID remains under-recognised. However, it is easily diagnosed and managed, and the recently revised 2021 European Society of Cardiology (ESC) guidelines on HF provide specific recommendations for its diagnosis and treatment. Prospective randomised controlled trials in patients with symptomatic HF with reduced ejection fraction (HFrEF) show that correction of ID using intravenous iron (principally ferric carboxymaltose [FCM]) provides improvements in symptoms of HF, exercise capacity and QoL, and a recent trial demonstrated that FCM therapy following hospitalisation due to acute decompensated HF reduced the risk of subsequent HF hospitalisations. This review provides a summary of the epidemiology and pathophysiology of ID in HFrEF, and practical guidance on screening, diagnosing, and treating ID.<\/jats:p>","DOI":"10.3390\/jcm11112976","type":"journal-article","created":{"date-parts":[[2022,5,25]],"date-time":"2022-05-25T08:41:33Z","timestamp":1653468093000},"page":"2976","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Practical Guidance for Diagnosing and Treating Iron Deficiency in Patients with Heart Failure: Why, Who and How?"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0075-805X","authenticated-orcid":false,"given":"Andrew","family":"Sindone","sequence":"first","affiliation":[{"name":"Heart Failure Unit, Department of Cardiac Rehabilitation, Concord Repatriation General Hospital, Concord, NSW 2139, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7598-708X","authenticated-orcid":false,"given":"Wolfram","family":"Doehner","sequence":"additional","affiliation":[{"name":"Berlin Institute of Health, Center for Regenerative Therapies (BCRT), Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, 10117 Berlin, Germany"},{"name":"Center for Stroke Research Berlin (CSB), Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, 10117 Berlin, Germany"},{"name":"Department of Internal Medicine and Cardiology, Campus Virchow-Klinikum, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, 10117 Berlin, Germany"},{"name":"German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, 10785 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Manito","sequence":"additional","affiliation":[{"name":"Heart Failure and Transplant Unit, Department of Cardiology, University of Barcelona, Bellvitge University Hospital, 08907 Barcelona, Spain"},{"name":"Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa","family":"McDonagh","sequence":"additional","affiliation":[{"name":"Department of Cardiology, King\u2019s College Hospital, London SE5 9RS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain","family":"Cohen-Solal","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Universite de Paris, UMRS 942, 75010 Paris, France"},{"name":"Lariboisi\u00e8re Hospital AP-HP, 75010 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4058-3848","authenticated-orcid":false,"given":"Thibaud","family":"Damy","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AP-HP, DHU A-TVB and GRC ARI, Henri Mondor University-Hospital, 94000 Cr\u00e9teil, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1672-7119","authenticated-orcid":false,"given":"Julio","family":"N\u00fa\u00f1ez","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Cl\u00ednico Universitario, Universidad de Valencia, INCLIVA 46010, 46010 Valencia, Spain"},{"name":"CIBER Cardiovascular, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6155-5494","authenticated-orcid":false,"given":"Otmar","family":"Pfister","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Basel, University of Basel, 4056 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"van der Meer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Groningen, University Medical Center Groningen, 9713 Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8780-720X","authenticated-orcid":false,"given":"Josep","family":"Comin-Colet","sequence":"additional","affiliation":[{"name":"Heart Failure and Transplant Unit, Department of Cardiology, University of Barcelona, Bellvitge University Hospital, 08907 Barcelona, Spain"},{"name":"Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.15420\/cfr.2016:25:2","article-title":"Global Public Health Burden of Heart Failure","volume":"3","author":"Savarese","year":"2017","journal-title":"Card. 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