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Prospective cardiac magnetic resonance imaging survey in myelodysplastic syndrome patients: insights from an Italian network.
- Source :
-
Annals of hematology [Ann Hematol] 2021 May; Vol. 100 (5), pp. 1139-1147. Date of Electronic Publication: 2021 Mar 19. - Publication Year :
- 2021
-
Abstract
- We prospectively evaluated changes in cardiac and hepatic iron overload (IO) and in morpho-functional cardiac parameters and myocardial fibrosis by magnetic resonance imaging (MRI) in patients with low-risk and intermediate-1-risk myelodysplastic syndromes (MDS). Fifty patients enrolled in the Myocardial Iron Overload in MyElodysplastic Diseases (MIOMED) study were followed for 12 months. IO was quantified by the T2* technique and biventricular function parameters by cine images. Macroscopic myocardial fibrosis was detected by late gadolinium enhancement technique. Twenty-eight patients (71.89±8.46 years; 8 females) performed baseline and follow-up MRIs. Thirteen patients had baseline hepatic IO, with a higher frequency among transfusion-dependent patients. Out of the 15 patients with a baseline MRI liver iron concentration <3 mg/g/dw, two (non-chelated) developed hepatic IO. Thirteen (46.4%) patients had an abnormal T2* value in at least one myocardial segment. One patient without hepatic IO and non-transfused had baseline global T2* <20 ms. Among the 15 patients with no baseline myocardial IO (MIO), 2 worsened. There was a significant increase in both left and right ventricular end-diastolic volume indexes. Thirty-six percent of patients showed myocardial fibrosis correlating with aging. Two new occurrences were detected at the follow-up. In conclusion, by a more sensitive segmental approach, MIO is quite frequent in MDS patients and it can be present also in non-transfused patients and in absence of detectable hepatic iron. The incidence of cardiac and hepatic IO and of myocardial fibrosis and the increase in biventricular volumes after a 12-month interval suggest performing periodic MRI scans to better manage MDS patients.
- Subjects :
- Aged
Female
Fibrosis
Humans
Iron Overload complications
Iron Overload diagnostic imaging
Italy epidemiology
Liver diagnostic imaging
Male
Middle Aged
Myelodysplastic Syndromes complications
Myelodysplastic Syndromes epidemiology
Myocardium pathology
Prospective Studies
Heart diagnostic imaging
Magnetic Resonance Imaging
Myelodysplastic Syndromes diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1432-0584
- Volume :
- 100
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Annals of hematology
- Publication Type :
- Academic Journal
- Accession number :
- 33742225
- Full Text :
- https://doi.org/10.1007/s00277-021-04495-y