{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T21:05:01Z","timestamp":1782248701133,"version":"3.54.5"},"reference-count":58,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T00:00:00Z","timestamp":1692576000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>The soluble transferrin receptor (sTfR) is a marker of tissue iron status, which could indicate an increased iron demand at the tissue level. The impact of sTfR levels on functional capacity and quality of life (QoL) in non-anemic heart failure (HF) patients with otherwise normal systemic iron status has not been evaluated. We conducted an observational, prospective, cohort study of 1236 patients with chronic HF. We selected patients with normal hemoglobin levels and normal systemic iron status. Tissue iron deficiency (ID) was defined as levels of sTfR &gt; 75th percentile (1.63 mg per L). The primary endpoints were the distance walked in the 6 min walking test (6MWT) and the overall summary score (OSS) of the Minnesota Living with Heart Failure Questionnaire (MLHFQ). The final study cohort consisted of 215 patients. Overall QoL was significantly worse (51 \u00b1 27 vs. 39 \u00b1 20, p-value = 0.006, respectively), and the 6 MWT distance was significantly worse in patients with tissue ID when compared to patients without tissue ID (206 \u00b1 179 m vs. 314 \u00b1 155, p-value &lt; 0.0001, respectively). Higher sTfR levels, indicating increased iron demand, were associated with a shorter distance in the 6 MWT (standardized \u03b2 = \u22120.249, p &lt; 0.001) and a higher MLHFQ OSS (standardized \u03b2 = 0.183, p-value = 0.008). In this study, we show that in patients with normal systemic iron parameters, higher levels of sTfR are strongly associated with an impaired submaximal exercise capacity and with worse QoL.<\/jats:p>","DOI":"10.3390\/jpm13081282","type":"journal-article","created":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T00:46:22Z","timestamp":1692665182000},"page":"1282","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Soluble Transferrin Receptor as Iron Deficiency Biomarker: Impact on Exercise Capacity in Heart Failure Patients"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-2916-2374","authenticated-orcid":false,"given":"Maria del Mar","family":"Ras-Jim\u00e9nez","sequence":"first","affiliation":[{"name":"Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), 08907 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Community Heart Failure Program, Cardiology Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Department of Internal Medicine, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7475-4145","authenticated-orcid":false,"given":"Ra\u00fal","family":"Ramos-Polo","sequence":"additional","affiliation":[{"name":"Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), 08907 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Community Heart Failure Program, Cardiology Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Cardiology Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josep","family":"Francesch Manzano","sequence":"additional","affiliation":[{"name":"Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), 08907 L\u2019Hospitalet de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Corbella Santano","sequence":"additional","affiliation":[{"name":"Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), 08907 L\u2019Hospitalet de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herminio","family":"Morillas Climent","sequence":"additional","affiliation":[{"name":"Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), 08907 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Community Heart Failure Program, Cardiology Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Cardiology Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N\u00faria","family":"Jose-Baz\u00e1n","sequence":"additional","affiliation":[{"name":"Community Heart Failure Program, Cardiology Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, 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":"Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), 08907 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Community Heart Failure Program, Cardiology Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Cardiology Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5758-6933","authenticated-orcid":false,"given":"Paloma","family":"Garcimartin Cerezo","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain"},{"name":"Advanced Practice Nurses, Hospital del Mar, Parc de Salut Mar, 08003 Barcelona, Spain"},{"name":"Biomedical Research in Heart Diseases, IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain"},{"name":"Escuela Superior de Enfermer\u00eda del Mar, Parc de Salut Mar, 08003 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4858-9566","authenticated-orcid":false,"given":"Sergi","family":"Yun Viladomat","sequence":"additional","affiliation":[{"name":"Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), 08907 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Community Heart Failure Program, Cardiology Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Department of Internal Medicine, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5511-8597","authenticated-orcid":false,"given":"Pedro","family":"Moliner Borja","sequence":"additional","affiliation":[{"name":"Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), 08907 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Community Heart Failure Program, Cardiology Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Cardiology Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blanca","family":"Torres Card\u00fas","sequence":"additional","affiliation":[{"name":"Primary Care Service Delta del Llobregat, Institut Catal\u00e0 de la Salut, 08820 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Maria","family":"Verd\u00fa-Rotellar","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain"},{"name":"Primary Care Service Litoral, Institut Catal\u00e0 de la Salut, 08023 Barcelona, Spain"},{"name":"Department of Medicine, Universitat Aut\u00f2noma de Barcelona, 08193 Barcelona, Spain"},{"name":"Department of Medicine, Universitat Pompeu Fabra, 08002 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3734-4777","authenticated-orcid":false,"given":"Carles","family":"Diez-L\u00f3pez","sequence":"additional","affiliation":[{"name":"Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), 08907 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Cardiology Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain"},{"name":"Advanced Heart Failure and Heart Trasplant Program, Cardiology Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, 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Biomedical Research Institute (IDIBELL), 08907 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Cardiology Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain"},{"name":"Advanced Heart Failure and Heart Trasplant Program, Cardiology Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"de Frutos Seminario","sequence":"additional","affiliation":[{"name":"Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), 08907 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Cardiology Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Advanced Heart Failure and Heart Trasplant Program, Cardiology Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Triguero-Llonch","sequence":"additional","affiliation":[{"name":"Cardiology Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Advanced Heart Failure and Heart Trasplant Program, Cardiology Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Enjuanes Grau","sequence":"additional","affiliation":[{"name":"Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), 08907 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Community Heart Failure Program, Cardiology Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Cardiology Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, 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