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La radiologia medica

29-04-2024 | Thalassemia | Cardiac Radiology

Multiparametric cardiac magnetic resonance in patients with thalassemia intermedia: new insights from the E-MIOT network

Authors: Antonella Meloni, Laura Pistoia, Paolo Ricchi, Filomena Longo, Valerio Cecinati, Francesco Sorrentino, Liana Cuccia, Elisabetta Corigliano, Vincenza Rossi, Riccardo Righi, Priscilla Fina, Stefania Renne, Luigi Barbuto, Vincenzo Positano, Filippo Cademartiri

Published in: La radiologia medica

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Abstract

Purpose

In a relatively large cohort of thalassemia intermedia (TI) patients, we systematically investigated myocardial iron overload (MIO), function, and replacement fibrosis using cardiac magnetic resonance (CMR), we assessed the clinical determinants of global heart T2* values, and we explored the association between multiparametric CMR findings and cardiac complications.

Materials and methods

We considered 254 beta-TI patients (43.14 ± 13.69 years, 138 females) consecutively enrolled in the Extension-Myocardial Iron Overload in Thalassemia project. MIO was quantified by T2* technique and biventricular function and atrial areas by cine images. Macroscopic myocardial fibrosis was detected by late gadolinium enhancement technique.

Results

Compared to never/sporadically transfused patients, regularly transfused (RT)-TI patients exhibited significantly lower global heart T2* values, biventricular end-diastolic volume indexes, left ventricular mass index, and cardiac index. In RT-TI patients, age and serum ferritin levels were the strongest predictors of global heart T2* values. Independently from the transfusional state, cardiac T2* values were not associated with biventricular function.
Of the 103 (40.6%) patients in whom the contrast medium was administrated, 27 (26.2%) had replacement myocardial fibrosis. Age, sex distribution, cardiac iron, and biventricular function parameters were comparable between patients without and without replacement myocardial fibrosis. Twenty-five (9.8%) patients had a history of cardiac complications (heart failure and arrhythmias). Increased age and replacement myocardial fibrosis emerged as significant risk markers for cardiac complications.

Conclusions

In TI, regular transfusions are associated with less pronounced cardiac remodeling but increase the risk of MIO. Replacement myocardial fibrosis is a frequent finding associated with cardiac complications.
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Metadata
Title
Multiparametric cardiac magnetic resonance in patients with thalassemia intermedia: new insights from the E-MIOT network
Authors
Antonella Meloni
Laura Pistoia
Paolo Ricchi
Filomena Longo
Valerio Cecinati
Francesco Sorrentino
Liana Cuccia
Elisabetta Corigliano
Vincenza Rossi
Riccardo Righi
Priscilla Fina
Stefania Renne
Luigi Barbuto
Vincenzo Positano
Filippo Cademartiri
Publication date
29-04-2024
Publisher
Springer Milan
Published in
La radiologia medica
Print ISSN: 0033-8362
Electronic ISSN: 1826-6983
DOI
https://doi.org/10.1007/s11547-024-01821-y