Observational studyEuropean heart journal2024
Intravenous iron therapy results in rapid and sustained rise in myocardial iron content through a novel pathway.
Observational study in European heart journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Impact of Intravenous Iron in patients with heart failure and Iron Deficiency: an updated Meta-analysis of Randomized controlled trials.BMC cardiovascular disorders · 2024Pooled it
- Changes in platelet count as a marker of myocardial iron uptake after administration of ferric carboxymaltose in patients with heart failure.Scientific reports · 2026Trial
- Intravenous ferric carboxymaltose in heart failure with iron deficiency (FAIR-HF2 DZHK05 trial): Sex-specific outcomes.European journal of heart failure · 2025Trial
- Anaemia predicts iron homoeostasis dysregulation and modulates the response to empagliflozin in heart failure with reduced ejection fraction: the EMPATROPISM-FE trial.European heart journal · 2025Trial
- Oral iron-induced stunting is associated with increased Christensenella abundance in a piglet model for human infants.European journal of nutrition · 2026Article
- Rationale and design of the RISE-HF trial: sucrosomial iron in heart failure.International journal of cardiology. Heart & vasculature · 2026Article
- Iron overload induced by ferric derisomaltose and ferric carboxymaltose both increase FGF-23 levels and lead to osteomalacia and bone loss in normal mice.Biometals : an international journal on the role of metal ions in biology, biochemistry, and medicine · 2026Article
- Iron Deficiency as a Modifiable Risk Factor in Heart Failure: Evidence and Recommendations.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2026Review
- Article
- Baseline serum ferritin predicts myocardial iron uptake following intravenous iron therapy - a hypothesis-generating study.European journal of heart failure · 2025Article
- Iron Deficiency in Heart Failure: Cellular Mechanisms and Therapeutic Implications.Journal of cardiovascular development and disease · 2025Review
- The Relationship Between Non-Transferrin-Bound Iron (NTBI), Labile Plasma Iron (LPI), and Iron Toxicity.International journal of molecular sciences · 2025Review
- Multiorgan Imaging for Interorgan Crosstalk in Cardiometabolic Diseases.Circulation research · 2025Review
- Diagnosis and treatment of iron deficiency in chronic heart failure : Position statement of the heart failure working group of the Austrian Society of Cardiology.Wiener klinische Wochenschrift · 2025Article
- Computational Prediction of Tissue Iron Dynamics in Iron Deficiency Anemia Following Intravenous Ferric Carboxymaltose Therapy.International journal of nanomedicine · 2025Article
- Myocardial iron intake following intravenous iron therapy with ferric carboxymaltose is sustained at 1 year despite recurrence of iron deficiency.British journal of haematology · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors.
Funding
Abstract
BACKGROUND AND
aimsIntravenous iron therapies contain iron-carbohydrate complexes, designed to ensure iron becomes bioavailable via the intermediary of spleen and liver reticuloendothelial macrophages. How other tissues obtain and handle this iron remains unknown. This study addresses this question in the context of the heart.
methodsA prospective observational study was conducted in 12 patients receiving ferric carboxymaltose (FCM) for iron deficiency. Myocardial, spleen, and liver magnetic resonance relaxation times and plasma iron markers were collected longitudinally. To examine the handling of iron taken up by the myocardium, intracellular labile iron pool (LIP) was imaged in FCM-treated mice and cells.
resultsIn patients, myocardial relaxation time T1 dropped maximally 3 h post-FCM, remaining low 42 days later, while splenic T1 dropped maximally at 14 days, recovering by 42 days. In plasma, non-transferrin-bound iron (NTBI) peaked at 3 h, while ferritin peaked at 14 days. Changes in liver T1 diverged among patients. In mice, myocardial LIP rose 1 h and remained elevated 42 days after FCM. In cardiomyocytes, FCM exposure raised LIP rapidly. This was prevented by inhibitors of NTBI transporters T-type and L-type calcium channels and divalent metal transporter 1.
conclusionsIntravenous iron therapy with FCM delivers iron to the myocardium rapidly through NTBI transporters, independently of reticuloendothelial macrophages. This iron remains labile for weeks, reflecting the myocardium's limited iron storage capacity. These findings challenge current notions of how the heart obtains iron from these therapies and highlight the potential for long-term dosing to cause cumulative iron build-up in the heart.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.