Role of iron metabolism in heart failure: From iron deficiency to iron overload

https://doi.org/10.1016/j.bbadis.2018.08.030Get rights and content
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Highlights

  • Overview of normal iron metabolism

  • Mechanisms of development of iron-deficient heart failure

  • Translational insights into iron supplementation for iron-deficient heart failure

  • Mechanism of development of iron-overload cardiomyopathy

  • Translational insights into treatment of iron-overload cardiomyopathy

Abstract

Iron metabolism is a balancing act, and biological systems have evolved exquisite regulatory mechanisms to maintain iron homeostasis. Iron metabolism disorders are widespread health problems on a global scale and range from iron deficiency to iron-overload. Both types of iron disorders are linked to heart failure. Iron play a fundamental role in mitochondrial function and various enzyme functions and iron deficiency has a particular negative impact on mitochondria function. Given the high-energy demand of the heart, iron deficiency has a particularly negative impact on heart function and exacerbates heart failure. Iron-overload can result from excessive gut absorption of iron or frequent use of blood transfusions and is typically seen in patients with congenital anemias, sickle cell anemia and beta-thalassemia major, or in patients with primary hemochromatosis. This review provides an overview of normal iron metabolism, mechanisms underlying development of iron disorders in relation to heart failure, including iron-overload cardiomyopathy, and clinical perspective on the treatment options for iron metabolism disorders.

Keywords

Heart failure
Cardiomyopathy
Hemochromatosis
Iron deficiency
Iron overload
Iron metabolism
Hepcidin
Genetic regulation
Mitochondrial function

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This article is part of a special issue entitled: Genetic and epigenetic regulation of aging and longevity edited by Jun Ren & Megan Yingmei Zhang.