Department of Diagnostic Imaging, Campus Bio Medico University, via Alvaro del Portillo 200, 00128 Rome, Italy.
Eur J Radiol. 2013 Sep;82(9):e441-7. doi: 10.1016/j.ejrad.2013.03.025. Epub 2013 Apr 29.
Myocardial T2 cardiovascular magnetic resonance provides a rapid and reproducible assessment of cardiac iron load in thalassemia patients. Although cardiac involvement is mainly characterized by left ventricular dysfunction caused by iron overload, little is known about right ventricular function. The aim of this study was to assess the relationship between T2 value in myocardium and left-right ventricular volumetric and functional parameters and to evaluate the existing associations between left-right ventricles volumetric and functional parameter, myocardial T2 values and blood ferritin levels.
A retrospective analysis of 208 patients with β-thalassemia major and thalassemia intermedia was performed (109 males and 99 females; mean age 37.7 ± 13 years; 143 thalassemia major, 65 thalassemia intermedia). Myocardial iron load was assessed by T2 measurements, and volumetric functions were analyzed using the steady state free precession sequence.
A significant correlation was observed between EFLV and T2 (p=0.0001), EFRV and T2 (p=0.0279). An inverse correlation was present between DVLV and T2 (p=0.0468), SVLV and T2 (p=0.0003), SVRV and T2 (p=0.0001). There was no significant correlation between cardiac T2 and LV-RV mass indices. A significant correlation was observed between T2 and serum ferritin levels (p<0.001) and between EFLV and serum ferritin (p<0.05).
Myocardial iron load assessed by T2 cardiac magnetic resonance is associated with deterioration in left-right ventricular function; this is more evident when T2 values fall below 14 ms. CMR appears to be a promising approach for cardiac risk evaluation in TM patients.
心肌 T2 心血管磁共振可快速、重复地评估地中海贫血患者的心脏铁负荷。尽管心脏受累主要表现为铁过载引起的左心室功能障碍，但对右心室功能知之甚少。本研究旨在评估心肌 T2 值与左右心室容积和功能参数之间的关系，并评估左右心室容积和功能参数、心肌 T2 值与血清铁蛋白水平之间的现有关联。
对 208 例β-地中海贫血和中间型地中海贫血患者（109 名男性和 99 名女性；平均年龄 37.7 ± 13 岁；143 例β-地中海贫血，65 例中间型地中海贫血）进行回顾性分析。通过 T2 测量评估心肌铁负荷，使用稳态自由进动序列分析容积功能。
EFLV 与 T2 之间存在显著相关性（p=0.0001），EFRV 与 T2 之间存在显著相关性（p=0.0279）。DVLV 与 T2 之间存在负相关（p=0.0468），SVLV 与 T2 之间存在负相关（p=0.0003），SVRV 与 T2 之间存在负相关（p=0.0001）。心脏 T2 与 LV-RV 质量指数之间无显著相关性。T2 与血清铁蛋白水平之间存在显著相关性（p<0.001），EFLV 与血清铁蛋白之间存在显著相关性（p<0.05）。
T2 心脏磁共振评估的心肌铁负荷与左右心室功能恶化相关；当 T2 值低于 14ms 时，相关性更为明显。CMR 似乎是 TM 患者心脏风险评估的一种很有前途的方法。
