Document Detail


Myocardial scarring by delayed enhancement cardiovascular magnetic resonance in thalassaemia major.
MedLine Citation:
PMID:  19491092     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cardiovascular magnetic resonance (CMR) by delayed enhancement (DE) enables visualisation of myocardial scarring, but no dedicated studies are available in thalassaemia major. OBJECTIVE: To investigate the prevalence, extent, clinical and instrumental correlates of myocardial fibrosis or necrosis by DE CMR in patients with thalassaemia major. PATIENTS: 115 Patients with thalassaemia major consecutively examined at an MRI laboratory. METHODS: DE images were acquired to quantify myocardial scarring. Myocardial iron overload was determined by multislice multiecho T2*. Cine images were obtained to evaluate biventricular function. RESULTS: DE areas were present in 28/115 patients (24%). The mean (SD) extent of DE was 3.9 (2.4)%. In 26 patients the location of fibrosis was not specific and patchy distribution was prevalent. Two patients showed transmural DE following coronary distribution. The DE group was significantly older than the no-DE group (31 (7.7) years vs 26 (7.7) years, p = 0.004). No significant relation with heart T2* values and biventricular function was found. A significant correlation was found between the presence of DE and changes in ECG (ECG abnormal in the DE group 22/28 patients and in the no-DE group 30/87 patients; chi(2) = 14.9; p<0.001). CONCLUSIONS: In patients with thalassaemia the significant presence of myocardial fibrosis/necrosis seems to be a time-dependent process correlating with cardiovascular risk factors and cardiac complications. Levels of HCV antibodies are significantly higher in the serum of patients with thalassaemia with myocardial fibrosis/necrosis. ECG changes showed a good accuracy in predicting myocardial scarring.
Authors:
A Pepe; V Positano; M Capra; A Maggio; C L Pinto; A Spasiano; G Forni; G Derchi; B Favilli; G Rossi; E Cracolici; M Midiri; M Lombardi
Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-06-01
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  95     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-29     Completed Date:  2009-10-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  1688-93     Citation Subset:  AIM; IM    
Affiliation:
MRI Laboratory, Institute of Clinical Physiology, CNR, and Gabriele Monasterio Foundation, Via Moruzzi 1, 56124 Pisa, Italy. alessia.pepe@ifc.cnr.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Cicatrix / pathology*
Female
Humans
Iron Overload / pathology
Magnetic Resonance Angiography / methods
Magnetic Resonance Imaging, Cine
Male
Myocardium / pathology*
Necrosis / pathology
Retrospective Studies
beta-Thalassemia / pathology*
Comments/Corrections
Comment In:
Heart. 2009 Oct;95(20):1646-7   [PMID:  19628469 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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