{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T12:04:05Z","timestamp":1788350645349,"version":"build-2803163510"},"reference-count":37,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2020,4,22]],"date-time":"2020-04-22T00:00:00Z","timestamp":1587513600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The effects of iron deficiency (ID) have been widely studied in heart failure (HF) with reduced ejection fraction. On the other hand, studies in HF with preserved ejection fraction (HFpEF) are few and have included small numbers of participants. The aim of this study was to assess the role that ID plays in functional capacity and quality of life (QoL) in HFpEF while comparing several iron-related biomarkers to be used as potential predictors. ID was defined as ferritin &lt;100 ng\/mL or transferrin saturation &lt;20%. Submaximal exercise capacity, measured by the 6-min walking test (6MWT), and QoL, assessed by the Minnesotta Living with Heart Failure Questionnaire (MLHFQ), were compared between iron deficient patients and patients with normal iron status. A total of 447 HFpEF patients were included in the present cross-sectional study, and ID prevalence was 73%. Patients with ID performed worse in the 6MWT compared to patients with normal iron status (ID 271 \u00b1 94 m vs. non-ID 310 \u00b1 108 m, p &lt; 0.01). They also scored higher in the MLHFQ, denoting worse QoL (ID 49 \u00b1 22 vs. non-ID 43 \u00b1 23, p = 0.01). Regarding iron metabolism biomarkers, serum soluble transferrin receptor (sTfR) was the strongest independent predictor of functional capacity (\u03b2 = \u221263, p &lt; 0.0001, R2 0.39) and QoL (\u03b2 = 7.95, p &lt; 0.0001, R2 0.14) in multivariate models. This study postulates that ID is associated with worse functional capacity and QoL in HFpEF as well, and that sTfR is the best iron-related biomarker to predict both. Our study also suggests that the effects of ID could differ among HFpEF patients by left ventricular ejection fraction.<\/jats:p>","DOI":"10.3390\/jcm9041199","type":"journal-article","created":{"date-parts":[[2020,4,23]],"date-time":"2020-04-23T02:10:52Z","timestamp":1587607852000},"page":"1199","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":49,"title":["Iron Deficiency: Impact on Functional Capacity and Quality of Life in Heart Failure with Preserved Ejection Fraction"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0681-799X","authenticated-orcid":false,"given":"Alex","family":"Alcaide-Aldeano","sequence":"first","affiliation":[{"name":"University of Barcelona, School of Medicine, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Garay","sequence":"additional","affiliation":[{"name":"Community Heart Failure Unit, Department of Cardiology, Bellvitge University Hospital, L\u2019Hospitalet de Llobregat, 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00eddia","family":"Alcoberro","sequence":"additional","affiliation":[{"name":"Community Heart Failure Unit, Department of Cardiology, Bellvitge University Hospital, L\u2019Hospitalet de Llobregat, 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4574-4252","authenticated-orcid":false,"given":"Santiago","family":"Jim\u00e9nez-Marrero","sequence":"additional","affiliation":[{"name":"Community Heart Failure Unit, Department of Cardiology, Bellvitge University Hospital, L\u2019Hospitalet de Llobregat, 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4858-9566","authenticated-orcid":false,"given":"Sergi","family":"Yun","sequence":"additional","affiliation":[{"name":"Community Heart Failure Unit, Department of Cardiology, Bellvitge University Hospital, L\u2019Hospitalet de Llobregat, 08907 Barcelona, Spain"},{"name":"Bellvitge Biomedical Research Institute (IDIBELL), L\u2019Hospitalet de Llobregat, 08907 Barcelona, Spain"},{"name":"Department of Internal Medicine, Bellvitge University Hospital, L\u2019Hospitalet de Llobregat, 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Tajes","sequence":"additional","affiliation":[{"name":"Community Heart Failure Unit, Department of Cardiology, Bellvitge University Hospital, L\u2019Hospitalet de Llobregat, 08907 Barcelona, Spain"},{"name":"Bellvitge Biomedical Research Institute (IDIBELL), L\u2019Hospitalet de Llobregat, 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4090-6571","authenticated-orcid":false,"given":"Elena","family":"Garc\u00eda-Romero","sequence":"additional","affiliation":[{"name":"Bellvitge Biomedical Research Institute (IDIBELL), L\u2019Hospitalet de Llobregat, 08907 Barcelona, Spain"},{"name":"Advanced Heart Failure Unit, Department of Cardiology, Bellvitge University Hospital, L\u2019Hospitalet de Llobregat, 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carles","family":"D\u00edez-L\u00f3pez","sequence":"additional","affiliation":[{"name":"Bellvitge Biomedical Research Institute (IDIBELL), L\u2019Hospitalet de Llobregat, 08907 Barcelona, Spain"},{"name":"Advanced Heart Failure Unit, Department of Cardiology, Bellvitge University Hospital, L\u2019Hospitalet de Llobregat, 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"Gonz\u00e1lez-Costello","sequence":"additional","affiliation":[{"name":"University of Barcelona, School of Medicine, 08036 Barcelona, Spain"},{"name":"Bellvitge Biomedical Research Institute (IDIBELL), L\u2019Hospitalet de Llobregat, 08907 Barcelona, Spain"},{"name":"Advanced Heart Failure Unit, Department of Cardiology, Bellvitge University Hospital, L\u2019Hospitalet de Llobregat, 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gemma","family":"Mateus-Porta","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bellvitge University Hospital, L\u2019Hospitalet de Llobregat, 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Cainzos-Achirica","sequence":"additional","affiliation":[{"name":"Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7916-1223","authenticated-orcid":false,"given":"Cristina","family":"Enjuanes","sequence":"additional","affiliation":[{"name":"Community Heart Failure Unit, Department of Cardiology, Bellvitge University Hospital, L\u2019Hospitalet de Llobregat, 08907 Barcelona, Spain"},{"name":"Bellvitge Biomedical Research Institute (IDIBELL), L\u2019Hospitalet de Llobregat, 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8780-720X","authenticated-orcid":false,"given":"Josep","family":"Com\u00edn-Colet","sequence":"additional","affiliation":[{"name":"University of Barcelona, School of Medicine, 08036 Barcelona, Spain"},{"name":"Community Heart Failure Unit, Department of Cardiology, Bellvitge University Hospital, L\u2019Hospitalet de Llobregat, 08907 Barcelona, Spain"},{"name":"Bellvitge Biomedical Research Institute (IDIBELL), L\u2019Hospitalet de Llobregat, 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5511-8597","authenticated-orcid":false,"given":"Pedro","family":"Moliner","sequence":"additional","affiliation":[{"name":"Community Heart Failure Unit, Department of Cardiology, Bellvitge University Hospital, L\u2019Hospitalet de Llobregat, 08907 Barcelona, Spain"},{"name":"Bellvitge Biomedical Research Institute (IDIBELL), L\u2019Hospitalet de Llobregat, 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,4,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1038\/nrcardio.2017.65","article-title":"Epidemiology of heart failure with preserved ejection fraction","volume":"14","author":"Dunlay","year":"2017","journal-title":"Nat. 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