Iron is an essential mineral required for a variety of vital biological functions. Despite being
vital for life, iron also has potentially toxic aspects. Iron has been investigated as a risk factor for
coronary artery disease (CAD), however, iron’s toxicity in CAD patients still remains controversial.
One possible mechanism behind the toxicity of iron is “ferroptosis”, a newly described form of irondependent
cell death. Ferroptosis is an iron-dependent form of regulated cell death that is distinct from
apoptosis, necroptosis, and other types of cell death. Ferroptosis has been reported in ischemiareperfusion
(I/R) injury and several other diseases. Recently, we reported that ferroptosis is a significant
form of cell death in cardiomyocytes. Moreover, myocardial hemorrhage, a major event in the
pathogenesis of heart failure, could trigger the release of free iron into cardiac muscle and is an independent
predictor of adverse left ventricular remodeling after myocardial infarction. Iron deposition in
the heart can now be detected with advanced imaging methods, such as T2 star (T2*) cardiac magnetic
resonance imaging, which can non-invasively predict iron levels in the myocardium and detect myocardial
hemorrhage, thus existing technology could be used to assess myocardial iron. We will discuss
the role of iron in cardiovascular diseases and especially with regard to myocardial I/R injury.