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Noninvasive Imaging Estimation of Myocardial Iron Repletion Following Administration of Intravenous Iron: The Myocardial-IRON Trial

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Autores de INCLIVA

Participantes ajenos a INCLIVA

  • Palau, P
  • Llacer, P
  • Facila, L
  • Almenar, L
  • Serrano, A
  • Montagud, V
  • Lopez-Vilella, R
  • Lupon, J
  • Comin-Colet, J
  • Myocardial-IRON Investigators

Grupos y Plataformas de I+D+i

Abstract

Background--Intravenous ferric carboxymaltose (FCM) improves symptoms, functional capacity, and quality of life in heart failure and iron deficiency. The mechanisms underlying these effects are not fully understood. The aim of this study was to examine changes in myocardial iron content after FCM administration in patients with heart failure and iron deficiency using cardiac magnetic resonance. Methods and Results--Fifty-three stable heart failure and iron deficiency patients were randomly assigned 1:1 to receive intravenous FCM or placebo in a multicenter, double-blind study. T2* and T1 mapping cardiac magnetic resonance sequences, noninvasive surrogates of intramyocardial iron, were evaluated before and 7 and 30 days after randomization using linear mixed regression analysis. Results are presented as least-square means with 95% CI. The primary end point was the change in T2* and T1 mapping at 7 and 30 days. Median age was 73 (65-78) years, with N-terminal pro-B-type natriuretic peptide, ferritin, and transferrin saturation medians of 1690 pg/ mL (1010-2828), 63 ng/mL (22-114), and 15.7% (11.0-19.2), respectively. Baseline T2* and T1 mapping values did not significantly differ across treatment arms. On day 7, both T2* and T1 mapping (ms) were significantly lower in the FCM arm (36.6 [34.6-38.7] versus 40 [38-42.1], P=0.025; 1061 [1051-1072] versus 1085 [1074-1095], P=0.001, respectively). A similar reduction was found at 30 days for T2* (36.3 [34.1- 38.5] versus 41.1 [38.9-43.4], P=0.003), but not for T1 mapping (1075 [1065-1085] versus 1079 [1069-1089], P=0.577). Conclusions--In patients with heart failure and iron deficiency, FCM administration was associated with changes in the T2* and T1 mapping cardiac magnetic resonance sequences, indicative of myocardial iron repletion.

© 2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is noncommercial and no modifications or adaptations are made

Datos de la publicación

ISSN/ISSNe:
2047-9980, 2047-9980

Journal of the American Heart Association  WILEY

Tipo:
Article
Páginas:
-
PubMed:
32067585

Citas Recibidas en Web of Science: 73

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Keywords

  • cardiac magnetic resonance; ferric carboxymaltose; heart failure; iron deficiency; myocardial iron

Campos de Estudio

Financiación

INSTITUTO SALUD CARLOS III (CB16/11/00420)

Proyectos y Estudios Clínicos

INCORPORACIÓN DE NUEVAS ÁREAS TEMÁTICAS Y NUEVOS GRUPOS AL CONSORCIO CIBER

Investigador Principal: JUAN SANCHIS FORES

CB16/11/00420 . INSTITUTO SALUD CARLOS III

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