The relationship of myocardial and liver T2* values with cardiac function and laboratory findings in transfusion-dependent thalassemia major patients: A retrospective cardiac MRI study

Sepideh Abdi; Negar Taheri; Fatemeh Zahedi Haghighi; Mahya Khaki; Homa Najafi; Mohammad Mehdi Hemmati Komasi; Behrooz Hassani

doi:10.34172/jcvtr.2023.31592

The relationship of myocardial and liver T2* values with cardiac function and laboratory findings in transfusion-dependent thalassemia major patients: A retrospective cardiac MRI study

J Cardiovasc Thorac Res. 2023;15(2):86-92. doi: 10.34172/jcvtr.2023.31592. Epub 2023 Jun 29.

Authors

Sepideh Abdi¹, Negar Taheri², Fatemeh Zahedi Haghighi³, Mahya Khaki⁴, Homa Najafi³, Mohammad Mehdi Hemmati Komasi³, Behrooz Hassani³

Affiliations

¹ Cancer Research Center, Cancer Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
² Cancer Research Institute, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.
³ Department of Radiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
⁴ Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.

Abstract

Introduction: Cardiac complications are the leading cause of death in thalassemia patients. It is assumed that progressive iron accumulation results in myocyte damage. Myocardial T2* measurement by cardiac MRI quantifies iron overload. We aimed to study the association between left and right ventricular (LV and RV) function and iron deposition estimation by cardiac MRI T2* in a sample of Iranian patients.

Methods: Cardiac MRI exams of 118 transfusion-dependent thalassemia major patients were evaluated retrospectively. Biventricular function and volume and myocardial and liver T2* values were measured. The demographic and lab data were registered. Poisson and chi-square regression analyses investigated the correlation between the T2* value and ventricular dysfunction.

Results: The study participants' mean (SD) age was 32.7y (9.02), and 47.46% were female. Forty-nine cases (41.52%) revealed at least uni-ventricular dysfunction. LV dysfunction was noted in 20 cases, whereas 47 patients revealed RV dysfunction. The risk of LV dysfunction was 5.3-fold higher in patients with cardiac T2* value less than 10msec (RR=5.3, 95% CI=1.6, 17.1, P<0.05). No association was found between age, liver T2* value, serum ferritin level, and chelation therapy with the risk of LV and RV dysfunction.

Conclusion: Cardiac MRI T2* measure is a good indicator of LV dysfunction. Moreover, MRI parameters, especially RV functional measures, may have a substantial role in patient management. Therefore, cardiac MRI should be included in beta-thalassemia patients' management strategies.

Keywords: Cardiac MRI; T2* Value; Thalassemia Major; Ventricular Function.