Cardiac iron and cardiac disease in males and females with transfusion-dependent thalassemia major: a T2* magnetic resonance imaging study

Early detection of cardiac involvement in thalassemia: From bench to bedside perspective

“…Several studies indicated that serum ferritin was not correlated with cardiac T2* [16,22,57,58] . However, other studies with larger population size showed a weak relationship between serum ferritin and heart T2* [56,[59][60][61] . Because serum ferritin is raised even in many common conditions such as inflammation or hepatic disease [14] , the controversial correlation could be from subjects with a different underlying status included in each study.…”

“…Patients with mild, moderate and severe cardiac iron overload (T2* 12-20, 8-12 and less than 8 ms, respectively) had impaired LVEF in [56] (r 2 = 0.003, P = 0.04) TM/776 patients Retrospective Significant relationship between cardiac R2* and ferritin / Marsella et al [59] (r = -0.359, P < 0.0001) TM/167 patients Prospective Myocardial T2* was correlated with serum ferritin / Tanner et al [60] (r = -0.34, P < 0.001) TM/19 patients, SCD/17 patients Cross sectional Cardiac 1/T2* was correlated with ferritin level / Wood et al [61] (r 2 = 0.33, P = 0.01) TM/106 patients Prospective No significant correlation between heart T2* and serum ferritin × Anderson et al [16] TM/60 patients Prospective Serum ferritin did not correlate with cardiac iron values × Merchant et al [57] TM/20 patients Prospective No correlation between serum ferritin and cardiac T2* × Kolnagou et al [58] TM/47 patients Retrospective Cardiac T2* was not associated with the serum ferritin × Bayraktaroğlu et al [22] TM: Thalassemia major; SCD: Sickle cell disease. TM/776 patients Retrospective Significant correlation between LVEF and cardiac R2* (r = -0.327, P < 0.0001) / Marsella et al [59] TM/106 patients Prospective Significant correlation of myocardial T2* below 20 ms with LVEF (r = 0.61, P < 0.0001), LVESVi (r = 0.50, P < 0.0001), and LV mass index (r = 0.40, P < 0.001) / Anderson et al [16] TM/167 patients Prospective Significant relationship between myocardial iron and LVEF (r = 0.57, P < 0.001) / Tanner et al [60] TM/67 patients Cross sectional Myocardial T2* related to LV diastolic function (EPFR, r = -0.20, P = 0.19; APFR, r = 0.49, P < 0.001; EPFR/APFR ratio, r = -0.62, P < 0.001) / Westwood et al [52] TM/33 patients Cross sectional Good correlation of DT, Tei index and E/Em index with cardiac T2* values (P < 0.05, r = 0.70-0.81) and weak correlation of E/A with T2* (P < 0.05, r = -0.44) / Barzin et al [84] TM/47 patients Retrospective Significant correlations of the myocardial T2* with LVESVi and LVEDVi (r = -0.32, P = 0.027; r = -0.29, P = 0.046, respectively) / Bayraktaroğlu et al [22] TM/19 patients, SCD/17 patients…”

International survey of T2* cardiovascular magnetic resonance in -thalassemia major

“…Other than myocarditis, there is also potential for a tachycardia-related cardiomyopathy or high cardiac output heart failure in these chronically anemic patients. 35 Expert opinion generally holds that occasional cases of fulminant heart failure have been seen with normal or only mildly abnormal myocardial T2*. There have been reports in the past of a more common occurrence of myocarditis from Greece, 36 but only one case report which showed myocarditis with a normal myocardial T2* but no heart failure.…”

Acute cardiac decompensation in a patient with beta‐thalassemia and diabetes mellitus following cessation of chelation therapy

“…Optimal values are >20 msec, and severe impairment is considered when <10 msec because the rate of heart failure has been shown to increase dramatically below this value. In this case, the T2 was 4.5 msec and therefore represents severe iron overload of the myocardium 9, 10, 11.…”