title: The relationship between the myocardial T2* value and left ventricular volumetric and functional parameters in thalassemia major patients.
abstract: OBJECTIVE
  Cardiac involvement in thalassemia major (TM) is mainly characterized by left ventricular dysfunction caused by iron overload. Cardiovascular magnetic resonance imaging (MRI) including myocardial T2* measurement is becoming increasingly popular for quantitatively evaluating myocardial iron overload. The aim of this study was to evaluate the relationship between the myocardial T2* value and left ventricular functional parameters and to examine the associations between the degree of cardiac iron load and various clinical parameters.
  
  
  METHODS
  A retrospective analysis of 47 patients (25 males and 22 females; mean age, 23.0±5.4 years) with TM was performed. Myocardial iron load was assessed by T2* measurements, and volumetric functions were analyzed using the steady state free precession sequence. RESULTS In patients with myocardial iron deposition (T2* < 20 ms), the mean left ventricular ejection fraction (LVEF) was 64.73±4.94%. The LVEF of patients with myocardial siderosis was significantly lower than that of patients without myocardial siderosis (r=0.35, P = 0.014). Inverse and significant correlations between both the left ventricular (LV) end-systolic volume index and the LV end-diastolic volume index and the myocardial T2* value (r=-0.32, P = 0.027 and r=-0.29, P = 0.046, respectively) were observed. There was an inverse correlation between the myocardial T2* value and the liver iron concentration (r=-0.31, P = 0.037). Cardiac T2* was not associated with serum ferritin levels, pre-transfusion hemoglobin levels or the annual red cell consumption rate.
  
  
  CONCLUSIONS
  Myocardial iron load assessed by cardiac MRI (T2*) is associated with deterioration in left ventricular function. Thalassemia major patients with myocardial siderosis may have LVEF values within normal limits, but this result must be interpreted cautiously.
authors.affiliation: Department of Radiology, Ege University School of Medicine, İzmir, Turkey. selenb2000@gmail.com
authors.forename: Selen
authors.initials: S
authors.lastname: Bayraktaroğlu
authors.forename: Yeşim
authors.initials: Y
authors.lastname: Aydinok
authors.forename: Dilek
authors.initials: D
authors.lastname: Yildiz
authors.forename: Hatice
authors.initials: H
authors.lastname: Uluer
authors.forename: Recep
authors.initials: R
authors.lastname: Savaş
authors.forename: Hüdaver
authors.initials: H
authors.lastname: Alper
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006352:Heart Ventricles / Q000473:pathology*; D006801:Humans; D007501:Iron / Q000378:metabolism; D019190:Iron Overload / Q000175:diagnosis; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D009206:Myocardium / Q000378:metabolism / Q000473:pathology*; D012189:Retrospective Studies; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000209:etiology; D055815:Young Adult; D017086:beta-Thalassemia / Q000150:complications*
chemical_list: D007501:Iron