Alessia Pepe1, Antonella Meloni, Zelia Borsellino, Liana Cuccia, Caterina Borgna-Pignatti, Aurelio Maggio, Gennaro Restaino, Francesco Gagliardotto, Vincenzo Caruso, Anna Spasiano, Aldo Filosa, Michele Centra, Domenico D'Ascola, Antonella Quarta, Angelo Peluso, Massimo Midiri, Giuseppe Rossi, Vincenzo Positano, Marcello Capra. 1. aCMR Unit, Fondazione 'G. Monasterio' CNR-Regione Toscana, Pisa bEmatologia-Emoglobinopatie, Civico ARNAS Hospital, Palermo cDepartment of Clinical and Experimental Medicine (Pediatrics), University of Ferrara, Ferrara dHaematology II with Thalassemia, 'V. Cervello' Hospital, Palermo eRadiology Department, 'John Paul II' Catholic University, Campobasso fCentro Talassemie, ARNAS Garibaldi, Catania gUOSD Centro per le Microcitemie, AORN Cardarelli, Napoli hDepartment of Microcitemia, 'Casa Sollievo della Sofferenza' Hospital, San Giovanni Rotondo (FG) iU.O. Microcitemie, A.O. 'Bianchi-Melacrino-Morelli', Reggio Calabria jEmatologia, 'A. Perrino' Hospital, Brindisi kMicrocitemia - Azienda Unità Sanitaria Locale TA/1, Presidio Ospedaliero Centrale, Taranto lDepartment of Radiology, University of Palermo, Palermo mEpidemiology and Biostatistics Unit, Institute of Clinical Physiology, CNR, Pisa, Italy.
Abstract
AIMS: Our aim was to evaluate the correlation between myocardial fibrosis detected using the late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) technique and chronic hepatitis C (CHC) in a large, retrospective, multicentre cohort of thalassemia major patients. METHODS: LGE images were acquired in 434 thalassemia major patients (233 men, 31 ± 9 years) enrolled in the MIOT (Myocardial Iron Overload in Thalassemia) study. Hepatitis C virus (HCV)-RNA tests were sensitive to detect more than 50 copies/ml. RESULTS: No patient manifested moderate/severe adverse events associated with the use of Gadobutrol. Myocardial fibrosis was detected in 90 (21%) patients. Among the 312 patients tested for HCV-RNA, there was a significant correlation between the presence of myocardial fibrosis and CHC (P = 0.011). Among the 62 patients with myocardial fibrosis tested for HCV-RNA, we found a significantly higher prevalence of diabetes mellitus in CHC patients versus the no-CHC patients (P = 0.049). CONCLUSION: Our findings support the use of the LGE CMR approach well tolerated in the thalassemia major patients with CHC. HCV infection can be involved in the pathogenesis of myocardial fibrosis through both myocarditis directly and the pancreas and liver damage with the development of diabetes indirectly. These patients could therefore benefit from cardioactive drugs and therapeutic interventions directed towards the eradication of virus.
AIMS: Our aim was to evaluate the correlation between myocardial fibrosis detected using the late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) technique and chronic hepatitis C (CHC) in a large, retrospective, multicentre cohort of thalassemia major patients. METHODS: LGE images were acquired in 434 thalassemia major patients (233 men, 31 ± 9 years) enrolled in the MIOT (Myocardial Iron Overload in Thalassemia) study. Hepatitis C virus (HCV)-RNA tests were sensitive to detect more than 50 copies/ml. RESULTS: No patient manifested moderate/severe adverse events associated with the use of Gadobutrol. Myocardial fibrosis was detected in 90 (21%) patients. Among the 312 patients tested for HCV-RNA, there was a significant correlation between the presence of myocardial fibrosis and CHC (P = 0.011). Among the 62 patients with myocardial fibrosis tested for HCV-RNA, we found a significantly higher prevalence of diabetes mellitus in CHCpatients versus the no-CHCpatients (P = 0.049). CONCLUSION: Our findings support the use of the LGE CMR approach well tolerated in the thalassemia major patients with CHC. HCV infection can be involved in the pathogenesis of myocardial fibrosis through both myocarditis directly and the pancreas and liver damage with the development of diabetes indirectly. These patients could therefore benefit from cardioactive drugs and therapeutic interventions directed towards the eradication of virus.
Authors: Antonella Meloni; Laura Pistoia; Paolo Ricchi; Maria Caterina Putti; Maria Rita Gamberini; Liana Cuccia; Giuseppe Messina; Francesco Massei; Elena Facchini; Riccardo Righi; Stefania Renne; Giuseppe Peritore; Vincenzo Positano; Filippo Cademartiri Journal: J Pers Med Date: 2022-03-04