Chronic heart failure Circulatory System Heart failure
Conditions
Interventions
Two groups of participants will be recruited:
1. Participants with chronic heart failure and an ejection fraction of less than 40% who are iron deficient as defined by the European Soc
Sponsors
University of Bristol
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Adults aged 18 and over 2. Diagnosis of chronic heart failure with reduced ejection fraction (HFrEF) 3. New York Heart Association (NYHA) class II and III symptoms 4. Able to attend for assessments 5. On stable, optimal treatment for heart failure. This includes stable pharmacological therapy and device therapy 6. Willingness to receive intravenous iron replacement therapy (if indicated)
Exclusion criteria
Exclusion criteria: 1. Unable to provide informed consent 2. Inability to participate in physical assessments for reasons other than HFrEF (e.g. musculoskeletal impairment, neurological disorder) 3. Severe COPD 4. Long term oxygen therapy 5. Uninvestigated anaemia 6. Active malignancy 7. Active bleeding source 8. Awaiting gastrointestinal investigations 9. Diagnosis of additional disease likely to significantly worsen over the following 12 months 10. Patients with diagnosis of heart failure with preserved ejection fraction or isolated right ventricular impairment 11. Previous allergic reaction to any intravenous iron preparation 12. NHYA class I and IV heart failure 13. Atrial fibrillation or frequent ectopy 14. Presence of cardiac device (pacemaker, implantable cardiac device, cardiac resynchronisation therapy) with frequent need for atrial pacing 15. Anticipated changes in heart failure treatment over the next 3 months 16. Taking immunosuppressive therapy 17. Known autoimmune or inflammatory disorders 18. Diagnosis of ongoing primary muscle or neurological disorder
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Muscle sympathetic nerve activity assessed by microneurography before and after treatment with intravenous iron therapy | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Levels of activity of the autonomic nervous system assessed by measured activity of physical observations such as heart rate, blood pressure, respiratory rate and cardiopulmonary function testing post exercise before and after treatment with intravenous iron therapy 2. Blood markers of inflammation before and after treatment with intravenous iron therapy | — |
Countries
United Kingdom
Outcome results
None listed