Antonella Meloni1, Nicola Martini1, Vincenzo Positano1, Antonio De Luca2, Laura Pistoia1, Sara Sbragi3, Anna Spasiano4, Tommaso Casini5, Pier Paolo Bitti6, Massimo Allò7, Paola Maria Grazia Sanna8, Raffaele De Caterina3, Gianfranco Sinagra2, Alessia Pepe9. 1. Magnetic Resonance Imaging Unit, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy. 2. Cardiovascular Department, University of Trieste, Trieste, Italy. 3. Cardiovascular Division, University of Pisa, Pisa, Italy. 4. Unità Operativa Semplice Dipartimentale Malattie Rare del Globulo Rosso, Azienda Ospedaliera di Rilievo Nazionale "A. Cardarelli", Napoli, Italy. 5. Centro Talassemie ed Emoglobinopatie, Ospedale "Meyer", Firenze, Italy. 6. Servizio Immunoematologia e Medicina Trasfusionale, Dipartimento dei Servizi, Presidio Ospedaliero "San Francesco" ASL Nuoro, Nuoro, Italy. 7. Ematologia Microcitemia, Ospedale San Giovanni di Dio, ASP Crotone, Crotone, Italy. 8. Servizio Trasfusionale Aziendale, Azienda Ospedaliero-Universitaria di Sassari, Sassari, Italy. 9. Magnetic Resonance Imaging Unit, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy. alessia.pepe@ftgm.it.
Abstract
BACKGROUND: We compared cardiovascular magnetic resonance segmental native T1 against T2* values for the detection of myocardial iron overload (MIO) in thalassaemia major and we evaluated the clinical correlates of native T1 measurements. METHODS: We considered 146 patients (87 females, 38.7 ± 11.1 years) consecutively enrolled in the Extension-Myocardial Iron Overload in Thalassaemia Network. T1 and T2* values were obtained in the 16 left ventricular (LV) segments. LV function parameters were quantified by cine images. Post-contrast late gadolinium enhancement (LGE) and T1 images were acquired. RESULTS: 64.1% of segments had normal T2* and T1 values while 10.1% had pathologic T2* and T1 values. In 526 (23.0%) segments, there was a pathologic T1 and a normal T2* value while 65 (2.8%) segments had a pathologic T2* value but a normal T1 and an extracellular volume (ECV) ≥ 25% was detected in 16 of 19 segments where ECV was quantified. Global native T1 was independent from gender or LV function but decreased with increasing age. Patients with replacement myocardial fibrosis had significantly lower native global T1. Patients with cardiac complications had significantly lower native global T1. CONCLUSIONS: The combined use of both segmental native T1 and T2* values could improve the sensitivity for detecting MIO. Native T1 is associated with cardiac complications in thalassaemia major.
BACKGROUND: We compared cardiovascular magnetic resonance segmental native T1 against T2* values for the detection of myocardial iron overload (MIO) in thalassaemia major and we evaluated the clinical correlates of native T1 measurements. METHODS: We considered 146 patients (87 females, 38.7 ± 11.1 years) consecutively enrolled in the Extension-Myocardial Iron Overload in Thalassaemia Network. T1 and T2* values were obtained in the 16 left ventricular (LV) segments. LV function parameters were quantified by cine images. Post-contrast late gadolinium enhancement (LGE) and T1 images were acquired. RESULTS: 64.1% of segments had normal T2* and T1 values while 10.1% had pathologic T2* and T1 values. In 526 (23.0%) segments, there was a pathologic T1 and a normal T2* value while 65 (2.8%) segments had a pathologic T2* value but a normal T1 and an extracellular volume (ECV) ≥ 25% was detected in 16 of 19 segments where ECV was quantified. Global native T1 was independent from gender or LV function but decreased with increasing age. Patients with replacement myocardial fibrosis had significantly lower native global T1. Patients with cardiac complications had significantly lower native global T1. CONCLUSIONS: The combined use of both segmental native T1 and T2* values could improve the sensitivity for detecting MIO. Native T1 is associated with cardiac complications in thalassaemia major.
Entities:
Keywords:
Cardiovascular diseases; Iron overload; Magnetic resonance imaging; Thalassaemia major
Authors: L J Anderson; S Holden; B Davis; E Prescott; C C Charrier; N H Bunce; D N Firmin; B Wonke; J Porter; J M Walker; D J Pennell Journal: Eur Heart J Date: 2001-12 Impact factor: 29.983
Authors: Mark A Westwood; Lisa J Anderson; David N Firmin; Peter D Gatehouse; Christine H Lorenz; Beatrix Wonke; Dudley J Pennell Journal: J Magn Reson Imaging Date: 2003-11 Impact factor: 4.813
Authors: John-Paul Carpenter; Taigang He; Paul Kirk; Michael Roughton; Lisa J Anderson; Sofia V de Noronha; Mary N Sheppard; John B Porter; J Malcolm Walker; John C Wood; Renzo Galanello; Gianluca Forni; Gualtiero Catani; Gildo Matta; Suthat Fucharoen; Adam Fleming; Michael J House; Greg Black; David N Firmin; Timothy G St Pierre; Dudley J Pennell Journal: Circulation Date: 2011-03-28 Impact factor: 29.690
Authors: John C Wood; Maya Otto-Duessel; Michelle Aguilar; Hanspeter Nick; Marvin D Nelson; Thomas D Coates; Harvey Pollack; Rex Moats Journal: Circulation Date: 2005-07-18 Impact factor: 29.690
Authors: P Kirk; M Roughton; J B Porter; J M Walker; M A Tanner; J Patel; D Wu; J Taylor; M A Westwood; L J Anderson; D J Pennell Journal: Circulation Date: 2009-10-02 Impact factor: 29.690
Authors: Dudley J Pennell; James E Udelson; Andrew E Arai; Biykem Bozkurt; Alan R Cohen; Renzo Galanello; Timothy M Hoffman; Michael S Kiernan; Stamatios Lerakis; Antonio Piga; John B Porter; John Malcolm Walker; John Wood Journal: Circulation Date: 2013-06-17 Impact factor: 29.690