1. Improvement of heart iron with preserved patterns of iron store by CMR-guided chelation therapy.
- Author
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Meloni A, Positano V, Ruffo GB, Spasiano A, D'Ascola DG, Peluso A, Keilberg P, Restaino G, Valeri G, Renne S, Midiri M, and Pepe A
- Subjects
- Adult, Cohort Studies, Female, Follow-Up Studies, Heart Diseases diagnosis, Humans, Iron Overload diagnosis, Male, Middle Aged, Prospective Studies, Risk Assessment, Treatment Outcome, beta-Thalassemia diagnosis, Chelation Therapy methods, Heart Diseases therapy, Iron Overload therapy, Magnetic Resonance Imaging, Cine methods, beta-Thalassemia therapy
- Abstract
Aims: [Formula: see text] multislice multiecho cardiac magnetic resonance (CMR) allows quantification of the segmental distribution of myocardial iron overload (MIO). We evaluated whether a preferential pattern MIO was preserved between two CMR scans in regularly chelated thalassaemia major (TM) patients., Methods and Results: We evaluated prospectively 259 TM patients enrolled in the MIO in Thalassaemia (MIOT) network with a CMR follow-up (FU) study at 18 ± 3 months and significant MIO at baseline. The [Formula: see text] in the 16 segments and the global value were calculated. Four main circumferential regions (anterior, septal, inferior and lateral) were defined. We identified two groups: severe (n = 80, global [Formula: see text] <10 ms) and mild-moderate MIO (n = 179, global [Formula: see text] = 10-26 ms). Based on the CMR reports, 56.4% of patients changed the chelation regimen. For each group, there was a significant improvement in the global heart as well as in regional [Formula: see text] values (P < 0.0001). At the baseline, the mean [Formula: see text] value over the anterior region was significantly lower than the values over the other regions, and the mean [Formula: see text] over the inferior region was significantly lower than the values over the septal and the lateral regions. The same pattern was present at the FU, with a little difference for patients with mild-moderate MIO., Conclusion: A preferential pattern of iron store in anterior and inferior regions was present at both CMRs, with an increment of [Formula: see text] values at FU due to a baseline CMR-guided chelation therapy. The anterior region seems the region in which the iron accumulates first and is removed later., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.)
- Published
- 2015
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