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Single iron infusion improved exercise capacity in people with the most common form of heart failure

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Single iron infusion improved exercise capacity in people with the most common form of heart failure

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A new study by investigators from the Mass General Brigham Heart and Vascular Institute found that a single iron infusion improved exercise capacity in people with heart failure with preserved ejection fraction (HFpEF) and iron deficiency. The findings suggest that replenishing iron could help address the physical limitations associated with this condition. Results were presented at the 2026 American Heart Association Scientific Sessions and published simultaneously in Circulation.

The IRON-MET HFpEF trial enrolled 65 participants with symptomatic HFpEF and iron deficiency, which affects more than 50% of patients with HFpEF. Their median age was 68 years, and 72% of participants were women. Forty-four participants were randomized to receive one 1,000-mg IV dose of ferric derisomaltose and 21 to receive placebo. Iron was administered intravenously because previous studies have demonstrated that oral iron is not beneficial in patients with other forms of heart failure, likely due to poor gastrointestinal absorption.

All participants underwent cardiopulmonary exercise testing before and 12 weeks after the infusion. At 12 weeks, peak oxygen uptake, or VO₂—which is a key indicator of cardiorespiratory fitness—improved by approximately 10% in the intervention group and was unchanged in the placebo group.

"Patients living with HFpEF are burdened with severe limitations in exercise tolerance," said lead author Gregory D. Lewis, director of heart failure at the Mass General Brigham Heart and Vascular Institute and professor of medicine at Harvard Medical School.


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