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Multi-Parametric Cardiac Magnetic Resonance for Prediction of Heart Failure Death in Thalassemia Major

We assessed the prognostic value of multiparametric cardiovascular magnetic resonance (CMR) in predicting death from heart failure (HF) in thalassemia major (TM). We considered 1398 white TM patients (30.8 ± 8.9 years, 725 women) without a history of HF at baseline CMR, which was performed within th...

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Autores principales: Meloni, Antonella, Pistoia, Laura, Gamberini, Maria Rita, Cuccia, Liana, Lisi, Roberto, Cecinati, Valerio, Ricchi, Paolo, Gerardi, Calogera, Restaino, Gennaro, Righi, Riccardo, Positano, Vincenzo, Cademartiri, Filippo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10001258/
https://www.ncbi.nlm.nih.gov/pubmed/36900034
http://dx.doi.org/10.3390/diagnostics13050890
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author Meloni, Antonella
Pistoia, Laura
Gamberini, Maria Rita
Cuccia, Liana
Lisi, Roberto
Cecinati, Valerio
Ricchi, Paolo
Gerardi, Calogera
Restaino, Gennaro
Righi, Riccardo
Positano, Vincenzo
Cademartiri, Filippo
author_facet Meloni, Antonella
Pistoia, Laura
Gamberini, Maria Rita
Cuccia, Liana
Lisi, Roberto
Cecinati, Valerio
Ricchi, Paolo
Gerardi, Calogera
Restaino, Gennaro
Righi, Riccardo
Positano, Vincenzo
Cademartiri, Filippo
author_sort Meloni, Antonella
collection PubMed
description We assessed the prognostic value of multiparametric cardiovascular magnetic resonance (CMR) in predicting death from heart failure (HF) in thalassemia major (TM). We considered 1398 white TM patients (30.8 ± 8.9 years, 725 women) without a history of HF at baseline CMR, which was performed within the Myocardial Iron Overload in Thalassemia (MIOT) network. Iron overload was quantified by using the T2* technique, and biventricular function was determined with cine images. Late gadolinium enhancement (LGE) images were acquired to detect replacement myocardial fibrosis. During a mean follow-up of 4.83 ± 2.05 years, 49.1% of the patients changed the chelation regimen at least once; these patients were more likely to have significant myocardial iron overload (MIO) than patients who maintained the same regimen. Twelve (1.0%) patients died from HF. Significant MIO, ventricular dysfunction, ventricular dilation, and replacement myocardial fibrosis were identified as significant univariate prognosticators. Based on the presence of the four CMR predictors of HF death, patients were divided into three subgroups. Patients having all four markers had a significantly higher risk of dying for HF than patients without markers (hazard ratio (HR) = 89.93; 95%CI = 5.62–1439.46; p = 0.001) or with one to three CMR markers (HR = 12.69; 95%CI = 1.60–100.36; p = 0.016). Our findings promote the exploitation of the multiparametric potential of CMR, including LGE, for better risk stratification for TM patients.
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spelling pubmed-100012582023-03-11 Multi-Parametric Cardiac Magnetic Resonance for Prediction of Heart Failure Death in Thalassemia Major Meloni, Antonella Pistoia, Laura Gamberini, Maria Rita Cuccia, Liana Lisi, Roberto Cecinati, Valerio Ricchi, Paolo Gerardi, Calogera Restaino, Gennaro Righi, Riccardo Positano, Vincenzo Cademartiri, Filippo Diagnostics (Basel) Article We assessed the prognostic value of multiparametric cardiovascular magnetic resonance (CMR) in predicting death from heart failure (HF) in thalassemia major (TM). We considered 1398 white TM patients (30.8 ± 8.9 years, 725 women) without a history of HF at baseline CMR, which was performed within the Myocardial Iron Overload in Thalassemia (MIOT) network. Iron overload was quantified by using the T2* technique, and biventricular function was determined with cine images. Late gadolinium enhancement (LGE) images were acquired to detect replacement myocardial fibrosis. During a mean follow-up of 4.83 ± 2.05 years, 49.1% of the patients changed the chelation regimen at least once; these patients were more likely to have significant myocardial iron overload (MIO) than patients who maintained the same regimen. Twelve (1.0%) patients died from HF. Significant MIO, ventricular dysfunction, ventricular dilation, and replacement myocardial fibrosis were identified as significant univariate prognosticators. Based on the presence of the four CMR predictors of HF death, patients were divided into three subgroups. Patients having all four markers had a significantly higher risk of dying for HF than patients without markers (hazard ratio (HR) = 89.93; 95%CI = 5.62–1439.46; p = 0.001) or with one to three CMR markers (HR = 12.69; 95%CI = 1.60–100.36; p = 0.016). Our findings promote the exploitation of the multiparametric potential of CMR, including LGE, for better risk stratification for TM patients. MDPI 2023-02-26 /pmc/articles/PMC10001258/ /pubmed/36900034 http://dx.doi.org/10.3390/diagnostics13050890 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Meloni, Antonella
Pistoia, Laura
Gamberini, Maria Rita
Cuccia, Liana
Lisi, Roberto
Cecinati, Valerio
Ricchi, Paolo
Gerardi, Calogera
Restaino, Gennaro
Righi, Riccardo
Positano, Vincenzo
Cademartiri, Filippo
Multi-Parametric Cardiac Magnetic Resonance for Prediction of Heart Failure Death in Thalassemia Major
title Multi-Parametric Cardiac Magnetic Resonance for Prediction of Heart Failure Death in Thalassemia Major
title_full Multi-Parametric Cardiac Magnetic Resonance for Prediction of Heart Failure Death in Thalassemia Major
title_fullStr Multi-Parametric Cardiac Magnetic Resonance for Prediction of Heart Failure Death in Thalassemia Major
title_full_unstemmed Multi-Parametric Cardiac Magnetic Resonance for Prediction of Heart Failure Death in Thalassemia Major
title_short Multi-Parametric Cardiac Magnetic Resonance for Prediction of Heart Failure Death in Thalassemia Major
title_sort multi-parametric cardiac magnetic resonance for prediction of heart failure death in thalassemia major
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10001258/
https://www.ncbi.nlm.nih.gov/pubmed/36900034
http://dx.doi.org/10.3390/diagnostics13050890
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