<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2393-6797</journal-id>
<journal-title><![CDATA[Revista Uruguaya de Medicina Interna ]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Urug. Med. Int.]]></abbrev-journal-title>
<issn>2393-6797</issn>
<publisher>
<publisher-name><![CDATA[Sociedad de Medicina Interna del Uruguay]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2393-67972022000300016</article-id>
<article-id pub-id-type="doi">10.26445/07.03.2</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Utilidad del hierro parenteral en pacientes con ferropenia con o sin anemia en una Unidad Multidisciplinaria de Insuficiencia Cardíaca: una experiencia nacional.]]></article-title>
<article-title xml:lang="en"><![CDATA[Usefulness of parenteral iron in iron deficiency patients with or without anemia in a Multidisciplinary Heart Failure Unit: a national experience.]]></article-title>
<article-title xml:lang="pt"><![CDATA[Utilidade do ferro parenteral em pacientes com deficiência de ferro com ou sem anemia em uma Unidade Multidisciplinar de Insuficiência Cardíaca: uma experiência nacional.]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Peréz Papadópulos]]></surname>
<given-names><![CDATA[Amalia Verónica]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ormaechea Gorricho]]></surname>
<given-names><![CDATA[Gabriela]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Araque]]></surname>
<given-names><![CDATA[Sara Hernández]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de la República Hospital de Clínicas - &#8220;Dr. Manuel Quintela&#8221; Clínica Médica A]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2022</year>
</pub-date>
<volume>7</volume>
<numero>3</numero>
<fpage>16</fpage>
<lpage>25</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_arttext&amp;pid=S2393-67972022000300016&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_abstract&amp;pid=S2393-67972022000300016&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_pdf&amp;pid=S2393-67972022000300016&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[resumen está disponible en el texto completo]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction:  Patients with Heart Failure (HF) are a very complex group, with multiple comorbidities and multi-medicated with a high rate of readmission due to decompensation. Iron deficiency has emerged as a frequent comorbidity that needs to be systematically investigated, given the importance of a timely and adequate treatment to improve quality of life and reduce hospitalization and mortality. Parenteral iron treatment has shed light on a holistic approach to patient care and has favorably impacted the evolution of patients in international studies, which has resulted in the incorporation of parenteral iron use in international guidelines for the management of patients with iron deficiency in HF. Regarding available types of iron, carboxymaltose iron is chosen because its administration is convenient, and it is possible to provide high doses of iron in a single administration.  Objective:  To determine the clinical impact of parenteral iron administration in a population of HF patients with reduced ejection fraction who present iron deficiency with or without anemia in a Multidisciplinary Heart Failure Unit (UMIC, in Spanish).  Methodology:  This is a prospective cohort study. Patients with HF who presented a reduced ejection fraction &lt; 40% were included; over 18 years of age, of any gender; with HF of any etiology; in a stable clinical situation and with prior informed consent. Patients on previous iron or erythropoietin treatment, transfused in the last 3 months and / or with a history of iron anaphylaxis were excluded. Iron metabolism and blood count were requested at the beginning. Iron deficiency was defined as ferritin &lt; 100ug/ l or between 100 and 300ug / l and an IST &lt; 20%. Iron carboxymaltose was administered according to weight and baseline hemoglobin. NYHA Functional Class (NYHA FC) was recorded and a quality-of-life test (Minnesota questionnaire) and a 6-minute walk test were performed before and after iron administration. The statistical software used for data processing was STATA v.16.0. The statistical significance value was set at alpha 0.05.  Results:  47 patients were included: 29 women and 18 men. Ischemic etiology was the most prevalent: 44.7%; idiopathic 23.4%, hypertensive 10.6% and valvular 10.6%. Out of the patients with iron deficiency included, 44.7% did not have anemia. Before the iron administration 79% were in NYHA FC I or II, 21% in NYHA FC III, no patients were in NYHA FC IV; the average value of the Minnesota questionnaire was 59 and the average 6-minute walk test (TM6M) was 180m. After iron administration, the Minnesota questionnaire value was 41.5 and the mean 6M walk was 240m, which was a statistically significant difference (p &lt; 0.05).  Conclusions:  The experience with the use of parenteral iron in patients with iron deficiency and HF at UMIC has clearly been beneficial. A positive impact is evidenced in the quality-of-life test and the 6-minute walk test. The results support the search and treatment of iron deficiency not related to the existence of anemia. This first national experience places us at the same level of international centers, prioritizing the systematic consideration of treatment.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo:  Introdução:  Pacientes com Insuficiência Cardíaca (IC) são um grupo muito complexo, com múltiplas comorbidades e multimedicados, com alto índice de readmissão por descompensação. A deficiência de ferro tem surgido como uma comorbidade frequente, a ser sistematicamente investigada dada a importância de seu tratamento oportuno e adequado, a fim de melhorar a qualidade de vida e reduzir hospitalizações e mortalidade. O tratamento parenteral com ferro lançou luz sobre uma abordagem holística aos pacientes e impactou favoravelmente a evolução dos pacientes em estudos internacionais, levando ao posicionamento do uso do ferro parenteral nas diretrizes internacionais para o manejo de pacientes com deficiência de ferro na IC. Em relação aos tipos de ferro disponíveis, o ferro carboximaltose é de escolha pela praticidade de sua administração, podendo-se administrar altas doses de ferro em uma única administração.  Objetivo: Determinar o impacto clínico da administração parenteral de ferro em uma população de pacientes com IC com fração de ejeção reduzida que apresentam deficiência de ferro com ou sem anemia em uma Unidade Multidisciplinar de Insuficiência Cardíaca (UMIC).  Metodologia: Este é um estudo de coorte prospectivo. Foram incluídos pacientes com IC que apresentavam fração de ejeção reduzida &lt; 40%; maiores de 18 anos, de qualquer gênero; com IC de qualquer etiologia; em situação clínica estável e com consentimento prévio informado. Pacientes em tratamento prévio com ferro ou eritropoietina, transfundidos nos últimos 3 meses e / ou com história de anafilaxia por ferro foram excluídos. O metabolismo do ferro e o hemograma foram solicitados no início. A deficiência de ferro foi definida como ferritina &lt; 100ug / l ou entre 100 e 300ug / le um IST &lt; 20%. A carboximaltose de ferro foi administrada de acordo com o peso e a hemoglobina basal. A CF NYHA foi registrada e um teste de qualidade de vida (questionário de Minnesota) e um teste de caminhada de 6 minutos foram realizados antes e após a administração de ferro. O software estatístico utilizado para o processamento dos dados foi o STATA v.16.0. O valor de significância estatística foi estabelecido em alfa 0,05.  Resultados:  foram incluídos 47 pacientes: 29 mulheres e 18 homens. A etiologia isquêmica foi a mais prevalente: 44,7%; idiopáticos 23,4%, hipertensos 10,6% e valvares 10,6%. Dos pacientes com deficiência de ferro incluídos, 44,7% não apresentavam anemia. A administração anterior de ferro 79% estavam em CF I ou II, 21% em CF III, nenhum paciente em CF IV; o valor médio do questionário de Minnesota foi 59 e a média do teste de caminhada de 6 minutos (TM6M) 180m. Após a administração do ferro, o valor do questionário de Minnesota foi de 41,5 e a média de 6M foi de 240m, sendo esta diferença estatisticamente significativa (p &lt; 0,05). Conclusões: A experiência com o uso de ferro parenteral em pacientes com deficiência de ferro e IC na UMIC tem sido claramente benéfica. Um impacto positivo é evidenciado no teste de qualidade de vida e no teste de caminhada de 6 minutos. Os resultados apóiam a busca e o tratamento da deficiência de ferro independente da existência de anemia. Esta primeira experiência nacional nos coloca em pé de igualdade com os centros internacionais, priorizando a consideração sistemática do tratamento.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[insuficiencia cardíaca]]></kwd>
<kwd lng="es"><![CDATA[clase funcional]]></kwd>
<kwd lng="es"><![CDATA[ferropenia]]></kwd>
<kwd lng="en"><![CDATA[heart failure]]></kwd>
<kwd lng="en"><![CDATA[functional class]]></kwd>
<kwd lng="en"><![CDATA[iron deficiency]]></kwd>
<kwd lng="pt"><![CDATA[insuficiência cardíaca]]></kwd>
<kwd lng="pt"><![CDATA[classe funcional]]></kwd>
<kwd lng="pt"><![CDATA[deficiência de ferro]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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