Relationship of Magnetic Resonance Imaging Estimation of Myocardial Iron to Left Ventricular Systolic and Diastolic Function in Thalassemia

Abstract

In patients with TDT, echocardiographic diastolic function parameters correlated poorly with EF and myocardial T2* and were thus not well-suited for risk stratification. Myocardial T2* had a strong relationship with EF and appears to be a promising approach for predicting the development of heart failure and for iron chelator dose adjustment.

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

“…A major co-ordinated international effort is needed to continue to improve access to T2* CMR, although the provision of affordable and adequate transfusions and iron chelation therapy are primary issues. 5 Renzo Galanello, 6 Fabrice Danjou, 6 Gianluca Forni, 7 Antonis Kattamis, 8 Vassilis Ladis, 8 Marouso Drossou, 9 Demetra Vini, 9 Andreas Michos, 10 Vassilios Perifanis, 11 Tuncay Hazirolan, 12 Ana Almeida, 13 Yesim Aydinok, 14 Selen Bayraktaroglu, 14 Mirella Rangelova, 15 Denka Stoyanova, 16 Valeria Kaleva, 17 Georgi Tonev, 18 Amal El-Beshlawy, 19 Mohsen Elalfy, 20 Ibrahim Al-Nasser, 21 Wing-Yan Au, 22 Shau-Yin Ha, 22 Chi-Kong Li, 23 Winnie Chiu-Wing Chu, 23,24 Lee-Lee Chan, 25 Meng-Yao Lu, 26 Lia Wahidiyat, 27 Manuela Merelles-Pulcini, 28 Juliano de Lara Fernandes, 29 Fernando Kay, 30 P. Joy Ho, 31 Jane S. Hankins, 32 Maria Cappellini, 33 Shahina Daar, 34 Jameela Sathar, 35 Ali Taher, 36 George Kontoghiorges, 37 …”

“…5 Myocardial T2* is the only validated non-invasive measure of myocardial iron loading and is superior for this purpose to surrogates such as serum ferritin, liver iron, ventricular ejection fraction and tissue Doppler parameters. 3,[6][7][8][9][10] Although worldwide survival is still poor, 11 life expectancy is increasing in some countries with regular blood transfusion and well-managed iron chelation therapy. [12][13][14] In most cases, chronic myocardial siderosis is both preventable and reversible with modern chelation regimes.…”

The relationship between myocardial t2* and left ventricular volumetric and functional parameters in thalassemia major patients

“…At that stage, the treatment is difficult, and the prognosis is poor (9,22). In the literature, there are reported echocardiographic studies evaluating several functional and volumetric parameters in thalassemia patients (23,24). MRI techniques have recently been used to detect myocardial iron load and cardiac function (9,10).…”

The relation of color m-mode flow propagation with cardiac iron load in patients with thalassemia major

“…Although some of these studies have demonstrated a significant correlation (25)(26)(27), others have not (11,28). The main limitation of TDI parameters is their dependence on heart rate.…”