Relation of myocardial T2* to right ventricular function in thalassaemia major.
OBJECTIVE
Myocardial T2* cardiovascular magnetic resonance (CMR) provides a rapid and reproducible measure of cardiac iron loading and is being increasingly used worldwide for monitoring of transfusion-dependent thalassaemia patients. Although myocardial siderosis (T2* <20 ms) is associated with impaired left ventricular (LV) function, little is known of its relation with right ventricular (RV) function. The aim of this study was to investigate the relationship between cardiac T2* and RV function.


RESULTS
A retrospective analysis of 319 patients with beta-thalassaemia major presenting for their first CMR scan was performed (45.1% male, mean age 25.6 years). In patients with normal myocardial T2* (>20 ms), the RV ejection fraction (EF) was within the normal range in 98% of patients. When myocardial T2* was <20 ms, there was a progressive and significant decline in RV EF. There was a linear relationship between RV and LV EF.


CONCLUSIONS
Myocardial iron deposition is strongly associated with RV dysfunction, which mirrors the decrease in LV function seen with worsening cardiac iron loading. Right ventricular dysfunction may play a significant role in heart failure associated with myocardial siderosis.
Alpendurada
Francisco
F
Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK.
Carpenter
John-Paul
JP
Deac
Monica
M
Kirk
Paul
P
Walker
J Malcolm
JM
Porter
John B
JB
Banya
Winston
W
He
Taigang
T
Smith
Gill C
GC
Pennell
Dudley J
DJ
D000328:Adult; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006352:Heart Ventricles; D006486:Hemosiderosis / Q000150:complications / Q000503:physiopathology; D006801:Humans; D007501:Iron / Q000378:metabolism; D018810:Magnetic Resonance Angiography; D008297:Male; D012189:Retrospective Studies; D013318:Stroke Volume; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis* / Q000503:physiopathology; D017086:beta-Thalassemia / Q000150:complications* / Q000503:physiopathology
D007501:Iron