Abstract 4371488: Impact of Iron Supplementation on Functional Capacity in Adults with Pulmonary Hypertension: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
Background: Iron deficiency is a common comorbidity in patients with pulmonary hypertension (PH), affecting approximately 43–60% of this population. Iron plays a crucial role in oxygen transport and cellular energy metabolism, and its deficiency has been associated with impaired exercise tolerance and worse clinical outcomes. While intravenous iron supplementation, has shown promise in improving functional parameters in heart failure, its role in PH remains less well defined. A systematic synthesis of the evidence is warranted to better understand the potential therapeutic value of iron supplementation in this high-risk population. Hypothesis: Our hypothesis proposes that iron supplementation may significantly improve functional outcomes in PH patients with documented iron deficiency. Methods: We conducted a systematic review and meta-analysis to evaluate the effect of iron supplementation on the functional capacity in adults with PH. We used PubMed, MEDLINE and EMBASE for our systematic search of relevant studies published between 2014-2024. The studies reported a change in functional capacity with a 6-minute walk test (6MWT) distance. To assess study quality, we used the Newcastle- Ottawa Scale for observational studies and Jadad score for randomized controlled trials (RCTs). Using random-effects models, we calculated the mean differences with a 95% confidence interval. Results: From the collected studies, nine studies met the inclusion criteria (Figure 1). The pooled effect showed a significant improvement in 6MWT distance following iron supplementation (28.64 meters; 95% CI: 16.64 to 40.64; p < 0.01) with a substantial heterogeneity (78.5%) (Figure 2) . Of the studies considered, high-quality RCTs displayed smaller, non-significant changes (10.65 meters; 95% CI: -10.81 to 32.11) and non-randomized studies showed larger effects on functional capacity (31.68 meters; 95% CI: 21.90 to 41.45) (Figure 3). Improvements were more evident in patients with anemia at baseline. Conclusions: Iron supplementation may improve functional capacity in patients with pulmonary hypertension, particularly those with anemia. However, heterogeneity, potential bias, and differences between randomized and non-randomized studies limit the strength of current evidence. Well-designed, adequately powered trials are needed to clarify the clinical benefits and underlying mechanisms. Until then, iron therapy should be considered on a case-by-case basis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.024 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.020 | 0.036 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".