Association between norepinephrine levels and abnormal iron status in patients with chronic heart failure: is iron deficiency more than a comorbidity?

Background-¿Mechanisms underlying iron homeostasis dysregulation in patients with chronic heart failure remain unsettled. In cardiomyocyte models, norepinephrine may lead to intracellular iron depletion, but the potential association between catecholamines (sympathetic activation markers) and iron m...

Full description

Bibliographic Details
Authors: Moliner, Pedro, Enjuanes, Cristina, Tajes Orduña, Marta, Cainzos Achirica, Miguel, Lupón, Josep, Garay, Alberto, Jiménez Marrero, Santiago, Yun, Sergi, Farré, Núria, Cladellas Capdevila, Mercè, Díez López, Carles, González Costello, José, Comín Colet, Josep
Format: article
Status:Published version
Publication Date:2019
Country:España
Institution:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repository:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/171984
Online Access:https://hdl.handle.net/2445/171984
Access Level:Open access
Keyword:Anèmia
Insuficiència cardíaca
Sistema nerviós simpàtic
Anemia
Heart failure
Sympathetic nervous system
Description
Summary:Background-¿Mechanisms underlying iron homeostasis dysregulation in patients with chronic heart failure remain unsettled. In cardiomyocyte models, norepinephrine may lead to intracellular iron depletion, but the potential association between catecholamines (sympathetic activation markers) and iron metabolism biomarkers in chronic heart failure is unknown. Methods and Results-¿In this cross-sectional analysis, we studied the association between plasma norepinephrine levels and serum iron status biomarkers indicating iron storage (ferritin), iron transport (transferrin saturation), and iron demand (soluble transferrin receptor) in a prospective cohort of 742 chronic heart failure patients (mean age, 72 11 years; 56% male). Impaired iron status was defined as ferritin 0.05). Adjusted norepinephrine marginal means were significantly higher in patients with impaired iron status compared with those with normal iron status (528 pg/mL [505-551] versus 482 pg/mL [448-518], respectively; P=0.038). Conclusions-¿In chronic heart failure patients, increased sympathetic activation estimated with norepinephrine levels is associated with impaired iron status and, particularly, dysregulation of biomarkers suggesting impaired iron transport and increased iron demand. Whether the relationship between norepinephrine and iron metabolism is bidirectional and entails causality need to be elucidated in future research. (J Am Heart Assoc. 2019;8:e010887. DOI: 10.1161/JAHA.118.010887.)