title: Myocardial iron overload assessment by T2* magnetic resonance imaging in adult transfusion dependent patients with acquired anemias.
abstract: Only limited data are available regarding myocardial iron overload in adult patients with transfusion dependent acquired anemias. To address this topic using MRI T2* we studied 27 consecutive chronic transfusion dependent patients with acquired anemias: (22 myelodysplastic syndrome, 5 primary myelofibrosis). Cardiac MRI T2* values obtained ranged from 5.6 to 58.7 (median value 39.8) milliseconds. Of the 24 analyzable patients, cardiac T2* correlated with transfusion burden (p=0.0002). No patient who had received less than 290 mL/kg of packed red blood cells (101 units=20 grams of iron) had a pathological cardiac T2* value (< 20 ms). All patients who had received at least 24 PRBC units showed MRI T2* detectable hepatic iron (liver T2* value </=6.3 ms). Only patients with severe hepatic iron overload (T2* <1.4 ms) showed cardiac T2* value indicative of dangerous myocardial iron deposition. Serum ferritin was not significantly correlated with cardiac T2* (p=0.24). Gradient echo T2* magnetic resonance imaging provides a rapid and reproducible method for detecting myocardial iron overload which developed after a heavy transfusion burden equal to or greater than 290 mL/kg of packed red blood cell units.
authors.affiliation: U.O. Ematologia, Ospedale Oncologico "A. Businco", via Edward Jenner, 09121 Cagliari, Italy.
authors.forename: Anna Angela
authors.initials: AA
authors.lastname: Di Tucci
authors.forename: Gildo
authors.initials: G
authors.lastname: Matta
authors.forename: Simona
authors.initials: S
authors.lastname: Deplano
authors.forename: Attilio
authors.initials: A
authors.lastname: Gabbas
authors.forename: Cristina
authors.initials: C
authors.lastname: Depau
authors.forename: Daniele
authors.initials: D
authors.lastname: Derudas
authors.forename: Giovanni
authors.initials: G
authors.lastname: Caocci
authors.forename: Annalisa
authors.initials: A
authors.lastname: Agus
authors.forename: Emanuele
authors.initials: E
authors.lastname: Angelucci
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000628:therapy*; D005260:Female; D006801:Humans; D007501:Iron / Q000008:administration & dosage*; D019190:Iron Overload / Q000473:pathology*; D008099:Liver / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D065227:Transfusion Reaction
chemical_list: D007501:Iron