title: Normalized left ventricular volumes and function in thalassemia major patients with normal myocardial iron.
abstract: OBJECTIVE
  To determine the reference range in thalassemia major (TM) for left ventricular (LV) function.
  
  
  METHODS
  We used cardiovascular magnetic resonance (CMR) to measure heart volumes and function in 81 TM patients with normal myocardial T2* measurements (T2* > 20 msec) and by inference without excess myocardial iron. Forty age- and gender-matched healthy controls were also studied.
  
  
  RESULTS
  Resting LV volumes and function normalized to body surface area differed significantly between TM patients and controls. The lower limit and the mean for ejection fraction (EF) were higher in TM patients (males 59 vs. 55%, mean 71% vs. 65%; females 63 vs. 59%, mean 71% vs. 67%; both P < 0.001). The upper limit and mean for end-diastolic volume index were higher in TM patients (males 152 vs. 105 mL/m(2), mean 97 vs. 84 mL/m(2); females 121 vs. 99 mL/m(2), mean 87 vs. 79 mL/m(2); both P < 0.05). In TM patients the cardiac index (P < 0.001) was increased.
  
  
  CONCLUSIONS
  At rest, TM patients with a normal myocardial T2* have different "normal" values for LV volume and function parameters compared to controls, and this has the potential to lead to a misdiagnosis of cardiomyopathy. We present new reference "normal" ranges in TM to alleviate this problem.
authors.affiliation: Cardiovascular MR Unit, Royal Brompton Hospital and Imperial College, London, United Kingdom.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Westwood
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Anderson
authors.forename: Alicia M
authors.initials: AM
authors.lastname: Maceira
authors.forename: Farrukh T
authors.initials: FT
authors.lastname: Shah
authors.forename: Emma
authors.initials: E
authors.lastname: Prescott
authors.forename: John B
authors.initials: JB
authors.lastname: Porter
authors.forename: Beatrix
authors.initials: B
authors.lastname: Wonke
authors.forename: J Malcolm
authors.initials: JM
authors.lastname: Walker
authors.forename: Dudley J
authors.initials: DJ
authors.lastname: Pennell
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007501:Iron / Q000378:metabolism; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009206:Myocardium / Q000378:metabolism; D009929:Organ Size; D012016:Reference Values; D018709:Statistics, Nonparametric; D016276:Ventricular Function / Q000502:physiology*; D017086:beta-Thalassemia / Q000503:physiopathology*
chemical_list: D007501:Iron