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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...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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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. |
format | Online Article Text |
id | pubmed-10001258 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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