AHA: IV Iron Replacement Tied to Improved Exercise Capacity in HFpEF With Iron Deficiency

THURSDAY, Nov. 12, 2026 (HealthDay News) — For patients with heart failure with preserved ejection fraction (HFpEF) with iron deficiency (ID), ferric derisomaltose (FDI) improves measures of exercise capacity, according to a study published online Nov. 8 in Circulation to coincide with the American Heart Association Scientific Sessions 2026, held from Nov. 6 to 9 in Chicago.

Gregory D. Lewis, M.D., from Massachusetts General Hospital in Boston, and colleagues conducted a double-blind placebo-controlled randomized clinical trial of patients with HFpEF and ID to examine whether FDI improves peak oxygen uptake (VO₂) compared with placebo. Single-dose FDI (1,000 mg) or placebo was administered once intravenously (44 and 21 participants, respectively).

The researchers found that the peak VO₂ at 12 weeks improved by 1.2 mL/kg/min in the FDI group and remained unchanged (0.1 mL/kg/min) in the placebo group (least squares mean difference, 1.1 mL/kg/min). Significant improvements were also seen in VO₂ at the anaerobic threshold, six-minute walk test distance, and New York Heart Association class for FDI versus placebo, while no significant difference was seen in the Kansas City Cardiomyopathy Questionnaire-Overall Summary Score. Compared with the placebo group, FDI increased transferrin saturation and ferritin. No serious adverse events were seen in relation to FDI administration.

“Patients living with HFpEF are burdened with severe limitations in exercise tolerance,” Lewis said in a statement. “In the first study to comprehensively evaluate exercise response patterns to iron repletion in patients with HFpEF and iron deficiency, we found that ferric derisomaltose improved multiple measures of exercise capacity.”

Two authors disclosed ties to the pharmaceutical industry.

Abstract/Full Text

More Information