Document Detail


T2* magnetic resonance and myocardial iron in thalassemia.
MedLine Citation:
PMID:  16339685     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Magnetic resonance T2* values of the myocardium are directly related to tissue iron levels. Minor effects from myocardial oxygenation and fibrosis are overwhelmed by the highly dominant iron effect in clinically relevant levels of myocardial iron overload. Myocardial T2* values less than 20 ms indicate iron overload, and this is considered severe when T2* is less than 10 ms. Decreasing myocardial T2* levels are associated with systolic and diastolic ventricular dysfunction. Most recorded cases of heart failure in thalassemia to date have occurred in patients with very low T2* values (in the severe range). Exceptions to this have occurred in patients with other causes of heart failure such as concomitant congenital heart disease. In patients presenting with heart failure who undergo aggressive chelation with continuous intravenous deferoxamine, longitudinal studies show that myocardial T2* increases, and this is accompanied by increases in ejection fraction and relief of heart failure. In cross-sectional studies, the myocardial T2* and ejection fraction of patients on deferiprone was superior to that of patients on deferoxamine. Randomized controlled prospective trials comparing these two drugs for their action in clearing myocardial iron, as measured by myocardial T2*, are under way and should report in 2005/2006. These trials will clarify the role of different chelators in the management of myocardial iron overload and may be valuable in reducing the toll of death in thalassemia from heart failure.
Authors:
Dudley J Pennell
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Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  Annals of the New York Academy of Sciences     Volume:  1054     ISSN:  0077-8923     ISO Abbreviation:  Ann. N. Y. Acad. Sci.     Publication Date:  2005  
Date Detail:
Created Date:  2005-12-12     Completed Date:  2006-07-13     Revised Date:  2013-06-03    
Medline Journal Info:
Nlm Unique ID:  7506858     Medline TA:  Ann N Y Acad Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  373-8     Citation Subset:  IM    
Affiliation:
CMR Unit, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK. d.pennell@ic.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Transfusion / adverse effects
Calibration
Cardiomyopathies / etiology,  metabolism
Chelation Therapy
Child
Cohort Studies
Combined Modality Therapy
Deferoxamine / therapeutic use
Heart Failure / etiology,  metabolism
Humans
Iron / analysis*
Iron Chelating Agents / therapeutic use
Iron Overload / etiology,  metabolism*
Magnetic Resonance Imaging / methods*
Myocardium / chemistry*
Prospective Studies
Pyridones / therapeutic use
Randomized Controlled Trials as Topic
Reproducibility of Results
Stroke Volume
Thalassemia / complications,  drug therapy,  metabolism*,  therapy
Treatment Outcome
Chemical
Reg. No./Substance:
0/Iron Chelating Agents; 0/Pyridones; 2BTY8KH53L/deferiprone; 70-51-9/Deferoxamine; 7439-89-6/Iron

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


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