Effects of Iron Deficiency Anemia on Functional Status of Patients of Heart Failure with Reduced Ejection Fraction

Authors

  • Ahtasham Ul Hassan Department of General Medicine, Combined Military Hospital Multan/National University of Medical Sciences (NUMS) Pakistan
  • Farrukh Sher Department of General Medicine, Combined Military Hospital Multan/National University of Medical Sciences (NUMS) Pakistan
  • Aasim Ali Sajid Department of General Medicine, Combined Military Hospital Multan/National University of Medical Sciences (NUMS) Pakistan
  • Wasif Anwar Department of General Medicine, Combined Military Hospital Multan/National University of Medical Sciences (NUMS) Pakistan
  • Hafiz Muhammad Ahmar Aziz Department of General Medicine, Combined Military Hospital Multan/National University of Medical Sciences (NUMS) Pakistan
  • Muhammad Ahmad Department of General Medicine, Combined Military Hospital Multan/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76iSUPPL-7.13980

Keywords:

Anemia, Ejection Fraction, Exercise Test, Iron-Deficiency, Quality of Life

Abstract

Objective: To evaluate effects of iron deficiency anaemia on functional status of patients with heart failure with reduced ejection fraction (HfrEF).

Study Design: Analytical cross-sectional study.

Place and Duration of Study: Department of Medicine, Combined Military Hospital, Multan Pakistan, from Dec 2024 to Sep 2025.

Methodology: A total of 320 adult patients with chronic HFrEF were enrolled through consecutive sampling. Functional status was assessed by New York Heart Association (NYHA) class, six-minute walk test (6MWT) and Kansas City Cardiomyopathy Questionnaire (KCCQ). Iron deficiency was defined as serum ferritin <100 µg/L or 100–299 µg/L with transferrin saturation (TSAT) <20%. Haemoglobin, ferritin and TSAT were measured. Comparisons between IDA (Group-A) and non-IDA (Group-B) groups were performed. Multivariable linear regression was applied to identify independent predictors of 6MWT distance.

Results: Iron deficiency was observed in 196(61.3%) patients. Compared to non-deficient patients, those with IDA had lower mean haemoglobin (11.17±0.95 vs. 13.54±0.87 g/dL, p<0.001), ferritin (63.95 vs. 170.70 µg/L, p<0.001), TSAT (15.65% vs. 28.35%, p<0.001), 6MWT distance (280.98±44.56 vs. 303.32±42.51 m, p<0.001), and Kansas City Cardiomyopathy Questionnaire (KCCQ) scores (42.72±8.91 vs. 47.28±8.76, p<0.001). Regression analysis showed transferrin saturation (β=0.18, p=0.015) and haemoglobin (β=0.23, p=0.011) as independent predictors of six-minute walk test (6MWT) distance.

Conclusion: IDA significantly impairs functional capacity and quality of life in patients with HFrEF. Routine screening and correction of iron deficiency should be integrated into heart failure management to improve outcomes.

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References

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Published

15-07-2026

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How to Cite

1.
Hassan AU, Sher F, Sajid AA, Anwar W, Aziz HMA, Muhammad Ahmad. Effects of Iron Deficiency Anemia on Functional Status of Patients of Heart Failure with Reduced Ejection Fraction. Pak Armed Forces Med J [Internet]. 2026 Jul. 15 [cited 2026 Jul. 23];76(SUPPL-7). Available from: https://pafmj.org/PAFMJ/article/view/13980