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

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.