Iron Repletion in Heart Failure With Preserved Ejection Fraction: The IRONMET-HFpEF Randomized Trial.

Ferric derisomaltose (FDI) improved peak oxygen uptake at 12 weeks by 1.1 mL·kg−1·min−1 versus placebo in heart failure with preserved ejection fraction.

• Why it matters: Iron deficiency is common in HFpEF and is linked to worse exercise capacity and survival, but it was unknown whether intravenous iron repletion could improve objectively measured peak oxygen uptake.
• What they did: In a double-blind randomized trial of 65 participants with HFpEF and iron deficiency, a single 1000 mg intravenous dose of FDI (n=44) was compared with placebo (n=21), assessing peak oxygen uptake change from baseline to 12 weeks.
• The result: Peak oxygen uptake increased by 1.2 mL·kg−1·min−1 with FDI and was unchanged with placebo, with additional improvements in anaerobic threshold, 6-minute walk distance, and NYHA class, and no FDI-related serious adverse events.

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