Iron deficiency correction in heart failure patients with preserved ejection fraction: a case series study.

According to the European Society of Cardiology (ESC) guidelines, iron deficiency (ID) in patients with heart failure (HF) is defined as ferritin < 100 μg/l (absolute ID) or ferritin 100–300 μg/l combined with transferrin saturation (TSAT) < 20% (functional ID) [1]. ID is as highly prevalent is the chronic HF population as 30–79% [2]. Nevertheless, in patients with HF with preserved ejection fraction (HFpEF) ID is less studied: according to the meta-analysis by Beale et al. it is estimated as 59% in these subjects [3]. The ESC guidelines recommend (IC) that all patients with symptomatic chronic HF undergo screening for ID [1]. Since ID and HF share symptoms such as fatigue and dyspnoea, in HF patients ID is often underdiagnosed and not corrected. Indeed, only a dedicated blood sample establishes the diagnosis. Ferric carboxymaltose (FCM) is the most studied compound in HF and it is the only iron supplementation recommended by the ESC guidelines [1]. To the best of our knowledge no data have been published so far on the use of FCM in patients with HFpEF.