Diabetes, obesity and hypertension, all highly present comorbidities in HFpEF, seem to drive this disease by inducing low-grade systemic inflammation which in turn induces microvascular dysfunction and activates a cascade of events. Several studies have demonstrated that HFpEF is a systemic disease that affects not only cardiac, but also peripheral muscle energy metabolism. Iron deficiency (ID) could be an important contributor in this pathophysiological process. Iron deficiency is present in 5
Conditions
Interventions
o Measurement of PCR recovery time using MR spectroscopy
- Microvascular function
o Glycocalyx thickness (um)
o Heat induced hyperaemic response (% skin hyperaemic response)
- Exercise tolerance
Sponsors
Not aplicable
Eligibility
Inclusion criteria
Inclusion criteria: • HFpEF: according to the ESC guidelines (1) Signs and/or symptoms of heart failure, (2) LVEF ≥ 50%, (3) Elevated levels of natriuretic peptide (NT-proBNP > 125 pg/ml ~ 15 pmol/L) (4) one of the following additional criteria a) Relevant structural heart disease; LV hypertrophy, (LVmass index > 95 g/m2 in women, or >115 g/m2 in men) and/or LA enlargement (LA volume index >34 l/m2) b) Diastolic dysfunction (E/e’ ≥ 13, mean e’ septal and lateral wall < 9 cm/s) • Iron deficiency: serum ferritin < 100 µg/L or serum ferritin between 100-299 µg/L in combination with a transferrin saturation < 20%.
Exclusion criteria
Exclusion criteria: A potential subject who meets any of the following criteria will be excluded from participation in this study: - Reproductive age women - Any iron supplement (oral, iv) during the last 6 months prior to inclusion - Any chemotherapy in last year - Significant peripheral artery disease - Contraindication for CMR
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| -Is skeletal muscle metabolism impaired in HFpEF patients with iron deficiency, measured using CMR spectroscopy? | — |
Secondary
| Measure | Time frame |
|---|---|
| - Is microvascular function impaired in HFpEF patients with iron deficiency? - Is exercise tolerance decreased in HFpEF patients with iron deficiency? | — |
Contacts
Public ContactArantxa Barandiaran
Postbus 5800
Outcome results
None listed