Abstract
Iron deficiency is common in patients with heart failure and has independent clinical significance beyond anemia, being associated with reduced exercise capacity, impaired quality of life, and increased risk of heart failure hospitalization. In recent years, screening and treatment of iron deficiency have been increasingly emphasized in international heart failure guidelines. This narrative review summarizes current evidence on the diagnosis and management of iron deficiency in patients with heart failure, focusing on pathophysiological mechanisms, diagnostic criteria, and the efficacy of therapeutic strategies, particularly intravenous iron therapy. Randomized controlled trials and recent meta-analyses demonstrate that intravenous iron supplementation improves symptoms and exercise capacity and reduces heart failure–related hospitalizations, whereas its effect on cardiovascular mortality remains inconsistent across studies. The review also discusses challenges in clinical practice in Vietnam and proposes a pragmatic approach tailored to local conditions to improve the effectiveness of iron deficiency management in patients with heart failure.
