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
DOI:
https://doi.org/10.61919/jhrr.v4i2.961Keywords:
6MWT, Chronic heart failure, Ferric-carboxymaltose, Heart failure, Iron deficiency, Intravenous iron, NYHAAbstract
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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Copyright (c) 2024 Muhammad Zubair Khan, Waqas Ahmad Jan, Kheraj Mal, Deepak Lal, Rahid Ayaz, Syed Muhammad Nayab Ali
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