Cardiac iron measurement and iron chelation therapy in patients with beta thalassaemia major: experience from Taiwan

Abstract

Background The aims of our study were to evaluate (i) the relationship between cardiac T2* values and cardiac complications in Asian -thalassaemia major (TM) patients, and (ii) the association between cardiac T2* values and other parameters currently used to predict cardiac complications as a result of transfusion iron overload. Methods We examined the myocardial iron loads of 88 TM patients from Taiwan with cardiac T2* magnetic resonance imaging (MRI) and assessed the correlation between cardiac T2* values and serum ferritin levels, liver iron concentration and left ventricular ejection fraction (LVEF). We also determined the predictive value of these measurements for the development of arrhythmia. Results and conclusion In our group of Taiwanese patients, the relative risk for arrhythmia was 10 center dot 36 when cardiac T2* values were less than 10ms (compared with 10ms) and 1 center dot 98 when serum ferritin levels increased >2500ng mL1 (compared with 2500ng mL1). Serum ferritin levels correlated with cardiac T2* values in patients with abnormal myocardial iron loads (T2*<20ms, r=0 center dot 48, P=0 center dot 004, n = 34), but LVEF (measured by echocardiography) gave no indication of excess myocardial iron deposition (r=0 center dot 07, P=0 center dot 52) or of the risk of developing arrhythmia.