Hematinics in heart failure

Our research focused on iron deficiency in heart failure. Heart failure is a clinical syndrome which is characterized by a reduced pumping function of the heart. Many heart failure patients also have other diseases (comorbidity), of which iron deficiency is very common. Iron is an important part of the molecule hemoglobin, which is involved in oxygen transport in the human body. Moreover, iron has a role in the energy metabolism. Compared to heart failure patients without iron deficiency, patients with iron deficiency have more complaints, a reduced exercise tolerance and a worse prognosis. Treatment of iron deficiency with iron infusion leads to less complaint and less hospital admissions for heart failure. To date, little is known about the causes of iron deficiency in heart failure patients. My thesis focused on the causes of iron deficiency in heart failure patients. Our studies showed that iron deficiency can have multiple causes, for example the use of blood thinners or drugs that reduce the amount of acid that the stomach produces, reduced protein intake from the diet, symptoms of heart failure (breathlessness, swollen legs), inflammation and kidney failure. We also showed that there are several forms of iron deficiency, which should probably be treated differently. Each heart failure patient should be frequently screened for the presence of iron deficiency. Besides iron, vitamin B12 and folic acid are also important for the production of hemoglobin. Therefore, we also studied these vitamins. Compared to iron deficiency, vitamin B12 and folic acid deficiency are quite rare in heart failure patients.