ArticlePloS one2018
The crucial impact of iron deficiency definition for the course of precapillary pulmonary hypertension.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed, 46 citations in OpenAlex.
- Supplementation with Iron in Pulmonary Arterial Hypertension. Two Randomized Crossover Trials.Annals of the American Thoracic Society · 2021Trial
- Iron Homeostasis at High Altitude in Patients With Pulmonary Hypertension.Pulmonary circulation · 2026Article
- Iron Deficiency in Pulmonary Hypertension-Prevalence, Impact on Prognosis and Disease Burden in Pulmonary Arterial Hypertension and Pulmonary Hypertension Related to Hypoxia: A Review.International journal of molecular sciences · 2026Review
- Reduced gastrointestinal iron uptake in pulmonary arterial hypertension: a prospective cross-sectional study.Respiratory research · 2026Article
- Insights into Pulmonary Arterial Hypertension in Connective Tissue Diseases.Journal of clinical medicine · 2025Review
- Reassessment of the Current Iron Deficiency Definition in Pulmonary Hypertension.Pulmonary circulation · 2025Article
- Clinical and prognostic significance of various anemia types in pulmonary arterial hypertension.Frontiers in medicine · 2025Article
- Anemia of Inflammation.Advances in experimental medicine and biology · 2025Review
- Efficacy and safety of specific treatment combined with SGLT2-i in pulmonary hypertension.Frontiers in cardiovascular medicine · 2025Article
- Immature reticulocyte fraction: A novel biomarker of hemodynamic severity in pulmonary arterial hypertension.Pulmonary circulation · 2024Article
- Intravenous iron supplementation in pulmonary hypertension groups 1 to 4.International journal of medical sciences · 2024Article
- Connective tissue disease-associated pulmonary hypertension: A comprehensive review.Pulmonary circulation · 2023Review
- The combination of supervised and unsupervised learning based risk stratification and phenotyping in pulmonary arterial hypertension-a long-term retrospective multicenter trial.BMC pulmonary medicine · 2023Observational
- Iron deficiency and cardiovascular disease.European heart journal · 2023Article
- Bmpr2 mutant mice are an inadequate model for studying iron deficiency in pulmonary hypertension.Pulmonary circulation · 2022Article
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- Prognostic impact of hypochromic erythrocytes in patients with pulmonary arterial hypertension.Respiratory research · 2021Article
- Physiology and Inflammation Driven Pathophysiology of Iron Homeostasis-Mechanistic Insights into Anemia of Inflammation and Its Treatment.Nutrients · 2021Review
- Nutritional immunity: the impact of metals on lung immune cells and the airway microbiome during chronic respiratory disease.Respiratory research · 2021Review
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Authors and funding
14 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Imbalances of iron homeostasis are associated with an adverse clinical outcome of pulmonary hypertension (PH). Herein, we aimed to analyze the impact of iron deficiency (ID) in a real-life PH patient cohort according to different currently used ID definitions. In a retrospective study including 153 precapillary PH patients followed over a mean period of five years, iron deficiency was assessed according to five clinical definitions used in previous trials. The impact of ID on clinical, hematological and hemodynamic parameters was investigated. Depending on the different cutoff levels for serum ferritin and transferrin saturation, currently used ID definitions indicated a prevalence of either true or functional ID in 11 to 75 percent of PH patients. A good diagnostic accuracy was achieved by using the sTFRF/log ferritin (sTFRF) index, which identified 33 to 42 percent of PH patients as being iron deficient. The sTFRF index had the best prediction for the association between ID and clinical outcome. Iron deficient patients with precapillary PH had a significantly higher mortality as compared to non-iron deficiency subjects, which was true for both, PH patients with and without anemia. Although levels of the iron hormone hepcidin were rather affected by ID than by inflammation, they were not associated with the clinical course or mortality of PH subjects. To conclude, ID had a significant impact on the clinical course of precapillary PH patients. The appropriate use of robust biomarkers to define ID is a prerequisite to further evaluate the role of ID and the potential benefit of iron supplementation in precapillary PH patients.
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