The Outcome of Use of Intravenous Iron Carboxymaltose on the NYHA Class and the Six-Minute Walk-Test in Patients with Heart Failure: Assessing Functional Improvement

Authors

  • Muhammad Zubair Khan Frontier Corps Teaching Hospital (FCTH) - Shakas Peshawar - Pakistan.
  • Waqas Ahmad Jan Mardan Medical Complex - Mardan - Pakistan.
  • Kheraj Mal SICVD Sukkur - Pakistan.
  • Deepak Lal Pakistan and Zayed Military Hospital - Abu Dhabi - UAE.
  • Rahid Ayaz Lady Reading Hospital - Peshawar - Pakistan.
  • Syed Muhammad Nayab Ali Lady Reading Hospital - Peshawar - Pakistan

DOI:

https://doi.org/10.61919/jhrr.v4i2.961

Keywords:

6MWT, Chronic heart failure, Ferric-carboxymaltose, Heart failure, Iron deficiency, Intravenous iron, NYHA

Abstract

BACKGROUND: Chronic heart failure (CHF) significantly impairs quality of life and exercise capacity, often exacerbated by concurrent iron deficiency. Intravenous ferric-carboxymaltose (FCM) has shown promise in addressing these deficiencies, improving both biomarkers of iron status and functional outcomes.

OBJECTIVE: To evaluate the effects of intravenous ferric-carboxymaltose on functional class and exercise capacity, as measured by the six-minute walk-test (6MWT), in patients with iron-deficient chronic heart failure.

METHODS: This prospective, single-arm study was conducted from April to September 2023 at the Cardiology unit of Frontier Corps Teaching Hospital, Shakas Peshawar, and Mardan Medical Complex, Mardan, Pakistan. Participants underwent baseline evaluations including demographic information, medical histories, physical examinations, and functional tests such as the 6MWT. Follow-up evaluations after three months of FCM therapy assessed changes in functional indicators. Statistical analyses included tests for significance and descriptive statistics.

RESULTS: Sixty patients participated, with a mean age of 55.87 ± 13.22 years and a mean BMI of 28.14 ± 9.71 kg/m^2. Initial assessments showed a mean LVEF of 33.54 ± 6.68%, with 75% classified as NYHA class III. Baseline 6MWT completion was 10 laps. Initial mean hemoglobin was 11.82 g%, MCV 78.48 fl, TSat 20.43%, and serum iron 50.55 mcg/dL. After treatment, hemoglobin increased to 13.65 g%, MCV to 80.23 fl, TSat to 23.05%, and serum iron to 55.40 mcg/dL. Participants completed 19 laps in the 6MWT, with 63.34% improving to NYHA class II. P-values were <0.0001 for these changes, indicating statistical significance.

CONCLUSION: Intravenous ferric-carboxymaltose significantly enhances functional capacity and iron status in patients with CHF and iron deficiency, irrespective of anemia status. Future research should explore how comorbid conditions like hypertension, diabetes, and renal failure influence treatment outcomes.

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Author Biographies

Muhammad Zubair Khan, Frontier Corps Teaching Hospital (FCTH) - Shakas Peshawar - Pakistan.

MBBS, Consultant Cardiologist - Frontier Corps Teaching Hospital (FCTH) - Shakas Peshawar - Pakistan.

Waqas Ahmad Jan, Mardan Medical Complex - Mardan - Pakistan.

MBBS, Trainee Medical Officer of Cardiology - Mardan Medical Complex - Mardan - Pakistan.

Kheraj Mal, SICVD Sukkur - Pakistan.

FCPS, Associate Professor - SICVD Sukkur - Pakistan.

Deepak Lal, Pakistan and Zayed Military Hospital - Abu Dhabi - UAE.

MBBS, FCPS, Adult Cardiology - NICVD Karachi - Pakistan and Zayed Military Hospital - Abu Dhabi - UAE.

Rahid Ayaz, Lady Reading Hospital - Peshawar - Pakistan.

FCPS, PGR Interventional Cardiology - Lady Reading Hospital - Peshawar - Pakistan.

Syed Muhammad Nayab Ali, Lady Reading Hospital - Peshawar - Pakistan

MBBS, PGR Cardiology - Lady Reading Hospital - Peshawar - Pakistan.

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Published

2024-05-21

How to Cite

Khan, M. Z., Waqas Ahmad Jan, Kheraj Mal, Deepak Lal, Rahid Ayaz, & Syed Muhammad Nayab Ali. (2024). The Outcome of Use of Intravenous Iron Carboxymaltose on the NYHA Class and the Six-Minute Walk-Test in Patients with Heart Failure: Assessing Functional Improvement. Journal of Health and Rehabilitation Research, 4(2), 842–846. https://doi.org/10.61919/jhrr.v4i2.961