Correlation between T2* cardiovascular magnetic resonance with left ventricular function and mass in adolescent and adult major thalassemia patients with iron overload.
OBJECTIVE
to assess for a correlation between T2*CMR with LV function and mass in thalassemic patients with iron overload.


METHODS
a cross-sectional study on thalassemic patients was conducted between July and September 2010 at Cipto Mangunkusumo and Premier Hospitals, Jakarta, Indonesia. Clinical examinations, review of medical charts, electrocardiography, echocardiography, and T2*CMR were performed. Cardiac siderosis was measured by T2*CMR conduction time. Left ventricle diastolic and systolic functions, as well as LV mass index were measured using echocardiography. Correlations between T2*CMR and echocardiography findings, as well as serum ferritin were determined using Pearson's and Spearman's tests.


RESULTS
thirty patients aged 13-41 years were enrolled, of whom two-thirds had -thalassemia major and one-third had HbE/-thalassemia. Diastolic dysfunction was identified in 8 patients, whereas systolic function was normal in all patients. Increased LV mass index was found in 3 patients. T2*CMR conduction times ranged from 8.98 to 55.04 ms and a value below 20 ms was demonstrated in 14 patients. There was a statistically significant moderate positive correlation of T2*CMR conduction time with E/A ratio (r = 0.471, P = 0.009), but no correlation was found with LV mass index (r=0.097, P=0.608). A moderate negative correlation was found between T2*CMR and serum ferritin (r = -0.514, P = 0.004), while a moderate negative correlation was found between serum ferritin and E/A ratio (r = -0.425, P = 0.019).


CONCLUSIONS
T2*CMR myocardial conduction time has a moderate positive correlation with diastolic function, moderate negative correlation with serum ferritin, but not with LV mass index and systolic function.
Department of Child Health, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
Mulyadi M
MM
Djer
Shirley L
SL
Anggriawan
Djajadiman
D
Gatot
Pustika
P
Amalia
Sudigdo
S
Sastroasmoro
Patricia
P
Widjaja
D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D004452:Echocardiography / Q000379:methods; D004562:Electrocardiography / Q000379:methods; D005260:Female; D005293:Ferritins / Q000097:blood; D006352:Heart Ventricles / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007214:Indonesia; D019190:Iron Overload / Q000209:etiology / Q000503:physiopathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D013223:Statistics as Topic; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D017086:beta-Thalassemia / Q000097:blood / Q000150:complications / Q000503:physiopathology
D005293:Ferritins