1. Myocardial iron overload by cardiovascular magnetic resonance native segmental T1 mapping: a sensitive approach that correlates with cardiac complications
- Author
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Paola Maria Grazia Sanna, Anna Spasiano, Alessia Pepe, Nicola Martini, Antonio De Luca, Gianfranco Sinagra, Pier Paolo Bitti, Massimo Allò, Laura Pistoia, Tommaso Casini, Vincenzo Positano, Sara Sbragi, Raffaele De Caterina, Antonella Meloni, Meloni, A., Martini, N., Positano, V., De Luca, A., Pistoia, L., Sbragi, S., Spasiano, A., Casini, T., Bitti, P. P., Allo, M., Sanna, P. M. G., De Caterina, R., Sinagra, G., and Pepe, A.
- Subjects
Cardiovascular diseases ,Iron overload ,Magnetic resonance imaging ,Thalassaemia major ,Female ,Gadolinium ,Humans ,Magnetic Resonance Imaging, Cine ,Magnetic Resonance Spectroscopy ,Myocardium ,Predictive Value of Tests ,Ventricular Function, Left ,Contrast Media ,Iron Overload ,medicine.medical_specialty ,Left ,Combined use ,Myocardial iron ,030204 cardiovascular system & hematology ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Ventricular Function ,Late gadolinium enhancement ,Diseases of the circulatory (Cardiovascular) system ,Radiology, Nuclear Medicine and imaging ,Angiology ,Lv function ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,business.industry ,Research ,Cardiovascular disease ,Cine ,RC666-701 ,Cardiology ,Myocardial fibrosis ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background We compared cardiovascular magnetic resonance segmental native T1 against T2* values for the detection of myocardial iron overload (MIO) in thalassaemia major and we evaluated the clinical correlates of native T1 measurements. Methods We considered 146 patients (87 females, 38.7 ± 11.1 years) consecutively enrolled in the Extension-Myocardial Iron Overload in Thalassaemia Network. T1 and T2* values were obtained in the 16 left ventricular (LV) segments. LV function parameters were quantified by cine images. Post-contrast late gadolinium enhancement (LGE) and T1 images were acquired. Results 64.1% of segments had normal T2* and T1 values while 10.1% had pathologic T2* and T1 values. In 526 (23.0%) segments, there was a pathologic T1 and a normal T2* value while 65 (2.8%) segments had a pathologic T2* value but a normal T1 and an extracellular volume (ECV) ≥ 25% was detected in 16 of 19 segments where ECV was quantified. Global native T1 was independent from gender or LV function but decreased with increasing age. Patients with replacement myocardial fibrosis had significantly lower native global T1. Patients with cardiac complications had significantly lower native global T1. Conclusions The combined use of both segmental native T1 and T2* values could improve the sensitivity for detecting MIO. Native T1 is associated with cardiac complications in thalassaemia major.
- Published
- 2021