Imbalance of Iron Availability and Demand in Patients With Acute and Chronic Heart Failure.

BACKGROUND: Iron deficiency (ID) is a frequent comorbidity in patients with acute (AHF) and chronic heart failure (CHF) associated with morbidity and death. We aimed to better characterize iron homeostasis in patients with heart failure applying different biomarkers and to evaluate the accuracy of current ID definition by the European Society of Cardiology/American College of Cardiology/American Heart Association to indicate tissue iron availability and demand. METHODS AND RESULTS: We performed a retrospective cohort study investigating 277 patients with AHF and 476 patients with CHF between February 2021 and May 2022. Patients with AHF had more advanced ID than patients with CHF, reflected by increased soluble transferrin receptor and soluble transferrin receptor-ferritin index, and lower ferritin, serum iron, transferrin saturation, hepcidin, and reticulocyte hemoglobin. Decreased iron availability or increased tissue iron demand, reflected by increased soluble transferrin receptor-ferritin index and decreased reticulocyte hemoglobin, was found in 84.1% (AHF) and 28.0% (CHF) with absolute ID and in 50.0% (AHF) and 10.5% (CHF) with combined ID according to the current European Society of Cardiology/American College of Cardiology/American Heart Association-based ID definition. Low hepcidin expression as an indicator of systemic ID was found in 91.1% (AHF) and 80.4% (CHF) of patients with absolute ID and in 32.3% (AHF) and 18.8% (CHF) of patients with combined ID. ID definitions with higher specificity reduce the need for iron supplementation by 25.5% in patients with AHF and by 65.6% in patients with CHF. CONCLUSIONS: Our results suggest that the current European Society of Cardiology/American College of Cardiology/American Heart Association-based ID definition might overestimate true ID, particularly in CHF. More stringent thresholds for ID could more accurately identify patients with heart failure with reduced tissue iron availability who benefit from intravenous iron supplementation.

Low-Complexity Wideband Interference Mitigation for UWB ToA Estimation.

Reliable time of arrival (ToA) estimation in dense multipath (DM) environments is a difficult task, especially when strong interference is present. The increasing number of multiple services in a shared spectrum comes with the demand for interference mitigation techniques. Multiple receiver elements, even in low-energy devices, allow for interference mitigation by processing coherent signals, but computational complexity has to be kept at a minimum. We propose a low-complexity, linearly constrained minimum variance (LCMV) interference mitigation approach in combination with a detection-based ToA estimator. The performance of the method within a realistic multipath and interference environment is evaluated based on measurements and simulations. A statistical analysis of the ToA estimation error is provided in terms of the mean absolute error (MAE), and the results are compared to those of a band-stop filter-based interference blocking approach. While the focus is on receivers with only two elements, an extension to multiple elements is discussed as well. Results show that the influence of strong interference can be drastically reduced, even when the interference bandwidth exceeds 60% of the signal bandwidth. Moreover, the algorithm is robust to uncertainties in the angle of arrival (AoA) of the desired signal. Based on these results, the proposed mitigation method is well suited when the interference bandwidth is large and when computational power is a critical resource.