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Myocardial iron loading in patients with thalassemia major on deferoxamine chelation
- Source :
- Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance. 8(3)
- Publication Year :
- 2006
-
Abstract
- Heart failure secondary to myocardial iron loading remains the leading cause of death in thalassemia major (TM). We used cardiovascular magnetic resonance (CMR) to assess the prevalence of myocardial iron overload and ventricular dysfunction in a large cohort of TM patients maintained on conventional chelation treatment with deferoxamine.A mobile CMR scanner was transported from London, UK, to Sardinia, Italy where 167 TM patients were assessed for myocardial iron loading, B-natriuretic peptide (BNP), and ferritin. In patients with myocardial iron loading CMR assessments of ventricular function were also made.Myocardial iron loading (T2*20 ms) was present in 108 (65%) patients, which was severe (T2*8 ms) in 22 (13%). Impaired (56%) left ventricular (LV) ejection fraction (EF) was present in 5%, 20% and 62% of patients with mild, moderate or severe iron loading. Increasing myocardial iron was related to impaired LVEF (Rs = 0.57, p0.001), weakly related to serum ferritin (Rs = -0.34, p0.001), and not related to liver iron (Rs = 0.11, p = 0.26). BNP was weakly related to myocardial iron (Rs = -0.35, p0.001) and was abnormal in only 5 patients.Myocardial siderosis was found in two-thirds of thalassemia major patients on maintenance deferoxamine treatment. This was combined with a high prevalence of impaired LV function, the severity of which tracked the severity of iron deposition. BNP was not useful to assess myocardial siderosis.
- Subjects :
- Male
medicine.medical_specialty
Iron Overload
medicine.drug_class
Thalassemia
Siderophores
Deferoxamine
Ventricular Dysfunction, Left
Internal medicine
Natriuretic Peptide, Brain
medicine
Natriuretic peptide
Prevalence
Humans
Radiology, Nuclear Medicine and imaging
cardiovascular diseases
Cause of death
Ejection fraction
Chi-Square Distribution
Radiological and Ultrasound Technology
biology
medicine.diagnostic_test
business.industry
Myocardium
beta-Thalassemia
Magnetic resonance imaging
medicine.disease
Magnetic Resonance Imaging
Surgery
Ferritin
Italy
Heart failure
Ferritins
cardiovascular system
Cardiology
biology.protein
Female
Cardiology and Cardiovascular Medicine
business
Cardiomyopathies
medicine.drug
Subjects
Details
- ISSN :
- 10976647
- Volume :
- 8
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
- Accession number :
- edsair.doi.dedup.....86df10cf15d7aaf0484f2c58970acf0d