Different patterns of myocardial iron distribution by whole-heart T2* magnetic resonance as risk markers for heart complications in thalassemia major.

Massimo Midiri, Patrizia Toia, Angelo Zuccarelli, Alessia Pepe, Anna Spasiano, Cristina Salvatori, Patrizia Toia, Antonella Meloni, Gennaro Restaino, Zelia Borsellino, Gianluca Valeri, Vincenzo Positano, Vincenzo Caruso, Massimo Midiri

Risultato della ricerca: Articlepeer review

24 Citazioni (Scopus)

Abstract

BackgroundThe multislice multiecho T2* cardiovascular magnetic resonance (CMR) technique allows to detect different patterns of myocardial iron overload (MIO). The aim of this cross-sectional study was to verify the association between cardiac complications (heart failure and arrhythmias), biventricular dysfunction and myocardial fibrosis with different patterns of MIO in thalassemia major (TM) patients.MethodsWe considered 812 TM patients enrolled in the Myocardial Iron Overload in Thalassemia (MIOT) Network. The T2* value in all the 16 cardiac segments was evaluated.ResultsWe identified 4 groups of patients: 138 with homogeneous MIO (all segments with T2* < 20 ms), 97 with heterogeneous MIO (some segments with T2* < 20 ms, others with T2* ≥ 20 ms) and significant global heart iron (global heart T2* < 20 ms), 238 with heterogeneous MIO and no significant global heart iron, and 339 with no MIO (all segments with T2* ≥ 20 ms).Compared to patients with no MIO, patients with homogeneous MIO were more likely to have cardiac complications (odds ratio—OR = 2.67), heart failure (OR = 2.54), LV dysfunction (OR = 5.59), and RV dysfunction (OR = 2.26); patients with heterogeneous MIO and significant global heart iron were more likely to have heart failure (OR = 2.38) and LV dysfunction (OR = 2.39).ConclusionsCardiac complications, heart failure and dysfunction were correlated with MIO distribution with an increasing risk from the TM patients with no MIO to those with homogeneous MIO. Using a segmental approach, early iron deposit or homogeneous MIO patterns can be characterized to better tailor chelation therapy.
Lingua originaleEnglish
pagine (da-a)1012-1019
Numero di pagine8
RivistaINTERNATIONAL JOURNAL OF CARDIOLOGY
Volume177
Stato di pubblicazionePublished - 2014

All Science Journal Classification (ASJC) codes

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