Optimal method for early detection of cardiac disorders in thalassemia major patients: magnetic resonance imaging or echocardiography?
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(Moussavi Farideh) - Shahid Beheshti University of Medical Sciences Shohada Hospital Department of Pediatric Hematology
(Ghasabeh Mounes Aliyari) - Tehran University of Medical Sciences Imam Khomeini Hospital Advanced Diagnostic and Interventional Radiology Research Center
(Roodpeyma Shahla) - Shahid Beheshti University of Medical Sciences Modarres Hospital division of Pediatric cardiology
(Alavi Samin) - Shahid Beheshti University of Medical Sciences Mofid Hospital Department of Pediatric Hematology
(Shakiba Majid) - Tehran University of Medical Sciences Imam Khomeini Hospital Advanced Diagnostic and Interventional Radiology Research Center
(Gheiratmand Riaz) - Shahid Beheshti University of Medical Sciences Shohada Hospital Department of Pediatric Hematology
(Omidghaemi Maryam) - Shahid Beheshti University of Medical Sciences Shohada Hospital Department of Pediatric Hematology
Abstract
Background: Heart failure resulting from myocardial iron deposition is the most important cause of death in ¥â-thalassemia major (TM) patients. Cardiac T2*magnetic resonance imaging (MRI), echocardiography, and serum ferritin level serve as diagnostic methods for detecting myocardial iron overload. In this study, we aimed to evaluate the relationship between the above-mentioned methods.
Methods: T2*MRI and echocardiographic measurement of left ventricular (LV) systolic and diastolic function were performed in 63 patients. Serum ferritin level was measured. The relationships between all assessments were evaluated.
Results: There were 40 women and 23 men with a mean age of 23.7¡¾5.1 years (range, 15?35 years). There was no statistically significant correlation between serum ferritin level and LV systolic and diastolic function (P=0.994 and P=0.475, respectively). T2*MRI results had a significant correlation with ferritin level; 63.6% of patients with serum ferritin level £¾2,000 ng/mL had abnormal cardiac MRI, while none of the patients with ferritin level£¼1,000 ng/mL had abnormal cardiac MRI (P=0.001). There was no significant correlation between MRI findings and LV systolic function (P=1.00). However, we detected a significant difference between LV diastolic function and cardiac siderosis (P=0.03)
Conclusion: MRI findings are a good predictor of future cardiac dysfunction, even in asymptomatic TM patients; however, diastolic dysfunction may happen prior to cardiac siderosis in some patients, and echocardiography is able to diagnose this diastolic dysfunction while T2*MRI shows normal findings.
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Echocardiography, Iron over load, Serum ferritin level, Thalassemia major, T2* MRI
KMID :
0366220140490030182
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