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Gender Differences in Iron Overload and Left Ventricular Function in a Cohort of Thalassemia Major Patients: A Prospective Study of a Single Italian Center Using Cardiovascular Mag...

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Bibliographische Detailangaben
Zeitschriftentitel: Blood
Personen und Körperschaften: Volpato, Elisabetta, Cassinerio, Elena, Fasulo, Maria Rosaria, Pedrotti, Paola, Pedretti, Stefano, Dellegrottaglie, Santo, Cappellini, Maria Domenica, Roghi, Alberto
In: Blood, 110, 2007, 11, S. 3819-3819
Format: E-Article
Sprache: Englisch
veröffentlicht:
American Society of Hematology
Schlagwörter:
Cell Biology
Hematology
Immunology
Biochemistry
author_facet Volpato, Elisabetta
Cassinerio, Elena
Fasulo, Maria Rosaria
Pedrotti, Paola
Pedretti, Stefano
Dellegrottaglie, Santo
Cappellini, Maria Domenica
Roghi, Alberto
Volpato, Elisabetta
Cassinerio, Elena
Fasulo, Maria Rosaria
Pedrotti, Paola
Pedretti, Stefano
Dellegrottaglie, Santo
Cappellini, Maria Domenica
Roghi, Alberto
author Volpato, Elisabetta
Cassinerio, Elena
Fasulo, Maria Rosaria
Pedrotti, Paola
Pedretti, Stefano
Dellegrottaglie, Santo
Cappellini, Maria Domenica
Roghi, Alberto
spellingShingle Volpato, Elisabetta
Cassinerio, Elena
Fasulo, Maria Rosaria
Pedrotti, Paola
Pedretti, Stefano
Dellegrottaglie, Santo
Cappellini, Maria Domenica
Roghi, Alberto
Blood
Gender Differences in Iron Overload and Left Ventricular Function in a Cohort of Thalassemia Major Patients: A Prospective Study of a Single Italian Center Using Cardiovascular Magnetic Resonance.
Cell Biology
Hematology
Immunology
Biochemistry
author_sort volpato, elisabetta
spelling Volpato, Elisabetta Cassinerio, Elena Fasulo, Maria Rosaria Pedrotti, Paola Pedretti, Stefano Dellegrottaglie, Santo Cappellini, Maria Domenica Roghi, Alberto 0006-4971 1528-0020 American Society of Hematology Cell Biology Hematology Immunology Biochemistry http://dx.doi.org/10.1182/blood.v110.11.3819.3819 <jats:title>Abstract</jats:title> <jats:p>Introduction: cardiac failure due to secondary iron overload remains the main cause of death in patients with b-Thalassemia Major (TM). Cardiovascular Magnetic Resonance Imaging (CMR) T2* technique is a new tool to assess myocardial iron concentration that allows to tailor the optimal iron chelation treatment for each patient.</jats:p> <jats:p>Aim of the study: to assess left ventricular function and myocardial iron overload in a cohort of TM patients, cared at Hereditary Anemia Center in Milan, Italy.</jats:p> <jats:p>Methods and Results: In 91 TM patients (33 males/58 females, mean age 32 ± 6 yrs) myocardial iron loading was assessed with the use of CMR T2* measurements (CMR Tools, Cardiovascular Imaging Solutions, London, UK). Left ventricular ejection fraction (LVEF) was also assessed with CMR. In the overall group hemoglobin levels were 9.0 ± 1.0 g/dl; the mean serum ferritin levels and iron intake during the six months before CMR evaluation were 1507 ± 1884 ng/ml and 0.34 ± 0.08 mg/kg/die respectively. T2* was significantly different between females and males (24 ± 11 and 32 ± 12 ms, respectively; p &amp;lt; 0.0001), with significant differences in diabetes mellitus prevalence (17% vs 8%, p&amp;lt;0.01) but not in age, serum ferritin, iron intake and hemoglobin levels (Table 1). Seven (7.6%) asymptomatic females showed a severe cardiac iron overload (T2* ≤ 10 ms), 9 patients (9.9%) moderate (T2* between 10.1 and 14 ms), 15 patients (16.4%) mild cardiac iron overload (T2* between 14.1 and 20 ms) and 60 patients (65.9%) had normal T2* (&amp;gt; 20 ms). LVEF was significantly different between females and males (35% vs 57%, p&amp;lt;0.001) with evidence of a significant relationship between iron overload severity and LVEF impairment (r=0.92).</jats:p> <jats:p>Conclusions: CMR cardiac function and T2* assessment allow to detect pre-symptomatic cardiac iron overload. Females are more at risk for severe iron overload and left ventricular impairment. The prevalence of diabetes mellitus and compliance to chelation therapy could be relevant in explaining the gender differences.</jats:p> <jats:p>Clinical parameters and T2* values in men and women with thalassemia major Men p Women SD: standard deviation Number of patients (n. of pts) 33 - 58 Age ± SD (years) 33 ± 6 ns 32 ± 6 Hemoglobin levels ± SD (g/dl) 9.0 ± 1.7 ns 9.0 ± 0.8 Ferritin levels ± SD (ng/ml) 964 ± 891 ns 1821 ± 2216 Iron intake ± SD (mg/Kg/die) 0.30 ± 0.07 ns 0.36 ± 0.09 Mean T2* value ± SD (ms) 32 ± 12 &amp;lt;0.0001 24 ± 11 T2*&amp;lt; 10 ms (n. of pts) 0 - 7 T2* between 10.1 and 14 ms (n. of pts) 1 - 8 T2* between 14.1 and 20 ms (n. of pts) 7 - 8 T2* &amp;gt; 20 ms (n. of pts) 25 - 35 T2*&amp;lt; 10 ms (n. of pts) plus LVEF≤ 57 % 0/0 (0%) - 6/7 (85.7%) T2* between 10.1 and 14 ms (n. of pts) plus LVEF≤ 57 % 1/1 (100%) - 3/8 (37.5%) T2* between 14.1 and 20 ms (n. of pts) plus LVEF≤ 57 % 3/7 (42.8%) - 1/8 (12.5%) T2* &amp;gt; 20 ms (n. of pts) plus LVEF≤ 57 % 7/25 (28%) - 5/35 (14.3%)</jats:p> Gender Differences in Iron Overload and Left Ventricular Function in a Cohort of Thalassemia Major Patients: A Prospective Study of a Single Italian Center Using Cardiovascular Magnetic Resonance. Blood
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publishDateSort 2007
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source_id 49
title Gender Differences in Iron Overload and Left Ventricular Function in a Cohort of Thalassemia Major Patients: A Prospective Study of a Single Italian Center Using Cardiovascular Magnetic Resonance.
title_unstemmed Gender Differences in Iron Overload and Left Ventricular Function in a Cohort of Thalassemia Major Patients: A Prospective Study of a Single Italian Center Using Cardiovascular Magnetic Resonance.
title_full Gender Differences in Iron Overload and Left Ventricular Function in a Cohort of Thalassemia Major Patients: A Prospective Study of a Single Italian Center Using Cardiovascular Magnetic Resonance.
title_fullStr Gender Differences in Iron Overload and Left Ventricular Function in a Cohort of Thalassemia Major Patients: A Prospective Study of a Single Italian Center Using Cardiovascular Magnetic Resonance.
title_full_unstemmed Gender Differences in Iron Overload and Left Ventricular Function in a Cohort of Thalassemia Major Patients: A Prospective Study of a Single Italian Center Using Cardiovascular Magnetic Resonance.
title_short Gender Differences in Iron Overload and Left Ventricular Function in a Cohort of Thalassemia Major Patients: A Prospective Study of a Single Italian Center Using Cardiovascular Magnetic Resonance.
title_sort gender differences in iron overload and left ventricular function in a cohort of thalassemia major patients: a prospective study of a single italian center using cardiovascular magnetic resonance.
topic Cell Biology
Hematology
Immunology
Biochemistry
url http://dx.doi.org/10.1182/blood.v110.11.3819.3819
publishDate 2007
physical 3819-3819
description <jats:title>Abstract</jats:title> <jats:p>Introduction: cardiac failure due to secondary iron overload remains the main cause of death in patients with b-Thalassemia Major (TM). Cardiovascular Magnetic Resonance Imaging (CMR) T2* technique is a new tool to assess myocardial iron concentration that allows to tailor the optimal iron chelation treatment for each patient.</jats:p> <jats:p>Aim of the study: to assess left ventricular function and myocardial iron overload in a cohort of TM patients, cared at Hereditary Anemia Center in Milan, Italy.</jats:p> <jats:p>Methods and Results: In 91 TM patients (33 males/58 females, mean age 32 ± 6 yrs) myocardial iron loading was assessed with the use of CMR T2* measurements (CMR Tools, Cardiovascular Imaging Solutions, London, UK). Left ventricular ejection fraction (LVEF) was also assessed with CMR. In the overall group hemoglobin levels were 9.0 ± 1.0 g/dl; the mean serum ferritin levels and iron intake during the six months before CMR evaluation were 1507 ± 1884 ng/ml and 0.34 ± 0.08 mg/kg/die respectively. T2* was significantly different between females and males (24 ± 11 and 32 ± 12 ms, respectively; p &amp;lt; 0.0001), with significant differences in diabetes mellitus prevalence (17% vs 8%, p&amp;lt;0.01) but not in age, serum ferritin, iron intake and hemoglobin levels (Table 1). Seven (7.6%) asymptomatic females showed a severe cardiac iron overload (T2* ≤ 10 ms), 9 patients (9.9%) moderate (T2* between 10.1 and 14 ms), 15 patients (16.4%) mild cardiac iron overload (T2* between 14.1 and 20 ms) and 60 patients (65.9%) had normal T2* (&amp;gt; 20 ms). LVEF was significantly different between females and males (35% vs 57%, p&amp;lt;0.001) with evidence of a significant relationship between iron overload severity and LVEF impairment (r=0.92).</jats:p> <jats:p>Conclusions: CMR cardiac function and T2* assessment allow to detect pre-symptomatic cardiac iron overload. Females are more at risk for severe iron overload and left ventricular impairment. The prevalence of diabetes mellitus and compliance to chelation therapy could be relevant in explaining the gender differences.</jats:p> <jats:p>Clinical parameters and T2* values in men and women with thalassemia major Men p Women SD: standard deviation Number of patients (n. of pts) 33 - 58 Age ± SD (years) 33 ± 6 ns 32 ± 6 Hemoglobin levels ± SD (g/dl) 9.0 ± 1.7 ns 9.0 ± 0.8 Ferritin levels ± SD (ng/ml) 964 ± 891 ns 1821 ± 2216 Iron intake ± SD (mg/Kg/die) 0.30 ± 0.07 ns 0.36 ± 0.09 Mean T2* value ± SD (ms) 32 ± 12 &amp;lt;0.0001 24 ± 11 T2*&amp;lt; 10 ms (n. of pts) 0 - 7 T2* between 10.1 and 14 ms (n. of pts) 1 - 8 T2* between 14.1 and 20 ms (n. of pts) 7 - 8 T2* &amp;gt; 20 ms (n. of pts) 25 - 35 T2*&amp;lt; 10 ms (n. of pts) plus LVEF≤ 57 % 0/0 (0%) - 6/7 (85.7%) T2* between 10.1 and 14 ms (n. of pts) plus LVEF≤ 57 % 1/1 (100%) - 3/8 (37.5%) T2* between 14.1 and 20 ms (n. of pts) plus LVEF≤ 57 % 3/7 (42.8%) - 1/8 (12.5%) T2* &amp;gt; 20 ms (n. of pts) plus LVEF≤ 57 % 7/25 (28%) - 5/35 (14.3%)</jats:p>
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author Volpato, Elisabetta, Cassinerio, Elena, Fasulo, Maria Rosaria, Pedrotti, Paola, Pedretti, Stefano, Dellegrottaglie, Santo, Cappellini, Maria Domenica, Roghi, Alberto
author_facet Volpato, Elisabetta, Cassinerio, Elena, Fasulo, Maria Rosaria, Pedrotti, Paola, Pedretti, Stefano, Dellegrottaglie, Santo, Cappellini, Maria Domenica, Roghi, Alberto, Volpato, Elisabetta, Cassinerio, Elena, Fasulo, Maria Rosaria, Pedrotti, Paola, Pedretti, Stefano, Dellegrottaglie, Santo, Cappellini, Maria Domenica, Roghi, Alberto
author_sort volpato, elisabetta
container_issue 11
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container_title Blood
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description <jats:title>Abstract</jats:title> <jats:p>Introduction: cardiac failure due to secondary iron overload remains the main cause of death in patients with b-Thalassemia Major (TM). Cardiovascular Magnetic Resonance Imaging (CMR) T2* technique is a new tool to assess myocardial iron concentration that allows to tailor the optimal iron chelation treatment for each patient.</jats:p> <jats:p>Aim of the study: to assess left ventricular function and myocardial iron overload in a cohort of TM patients, cared at Hereditary Anemia Center in Milan, Italy.</jats:p> <jats:p>Methods and Results: In 91 TM patients (33 males/58 females, mean age 32 ± 6 yrs) myocardial iron loading was assessed with the use of CMR T2* measurements (CMR Tools, Cardiovascular Imaging Solutions, London, UK). Left ventricular ejection fraction (LVEF) was also assessed with CMR. In the overall group hemoglobin levels were 9.0 ± 1.0 g/dl; the mean serum ferritin levels and iron intake during the six months before CMR evaluation were 1507 ± 1884 ng/ml and 0.34 ± 0.08 mg/kg/die respectively. T2* was significantly different between females and males (24 ± 11 and 32 ± 12 ms, respectively; p &amp;lt; 0.0001), with significant differences in diabetes mellitus prevalence (17% vs 8%, p&amp;lt;0.01) but not in age, serum ferritin, iron intake and hemoglobin levels (Table 1). Seven (7.6%) asymptomatic females showed a severe cardiac iron overload (T2* ≤ 10 ms), 9 patients (9.9%) moderate (T2* between 10.1 and 14 ms), 15 patients (16.4%) mild cardiac iron overload (T2* between 14.1 and 20 ms) and 60 patients (65.9%) had normal T2* (&amp;gt; 20 ms). LVEF was significantly different between females and males (35% vs 57%, p&amp;lt;0.001) with evidence of a significant relationship between iron overload severity and LVEF impairment (r=0.92).</jats:p> <jats:p>Conclusions: CMR cardiac function and T2* assessment allow to detect pre-symptomatic cardiac iron overload. Females are more at risk for severe iron overload and left ventricular impairment. The prevalence of diabetes mellitus and compliance to chelation therapy could be relevant in explaining the gender differences.</jats:p> <jats:p>Clinical parameters and T2* values in men and women with thalassemia major Men p Women SD: standard deviation Number of patients (n. of pts) 33 - 58 Age ± SD (years) 33 ± 6 ns 32 ± 6 Hemoglobin levels ± SD (g/dl) 9.0 ± 1.7 ns 9.0 ± 0.8 Ferritin levels ± SD (ng/ml) 964 ± 891 ns 1821 ± 2216 Iron intake ± SD (mg/Kg/die) 0.30 ± 0.07 ns 0.36 ± 0.09 Mean T2* value ± SD (ms) 32 ± 12 &amp;lt;0.0001 24 ± 11 T2*&amp;lt; 10 ms (n. of pts) 0 - 7 T2* between 10.1 and 14 ms (n. of pts) 1 - 8 T2* between 14.1 and 20 ms (n. of pts) 7 - 8 T2* &amp;gt; 20 ms (n. of pts) 25 - 35 T2*&amp;lt; 10 ms (n. of pts) plus LVEF≤ 57 % 0/0 (0%) - 6/7 (85.7%) T2* between 10.1 and 14 ms (n. of pts) plus LVEF≤ 57 % 1/1 (100%) - 3/8 (37.5%) T2* between 14.1 and 20 ms (n. of pts) plus LVEF≤ 57 % 3/7 (42.8%) - 1/8 (12.5%) T2* &amp;gt; 20 ms (n. of pts) plus LVEF≤ 57 % 7/25 (28%) - 5/35 (14.3%)</jats:p>
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imprint American Society of Hematology, 2007
imprint_str_mv American Society of Hematology, 2007
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spelling Volpato, Elisabetta Cassinerio, Elena Fasulo, Maria Rosaria Pedrotti, Paola Pedretti, Stefano Dellegrottaglie, Santo Cappellini, Maria Domenica Roghi, Alberto 0006-4971 1528-0020 American Society of Hematology Cell Biology Hematology Immunology Biochemistry http://dx.doi.org/10.1182/blood.v110.11.3819.3819 <jats:title>Abstract</jats:title> <jats:p>Introduction: cardiac failure due to secondary iron overload remains the main cause of death in patients with b-Thalassemia Major (TM). Cardiovascular Magnetic Resonance Imaging (CMR) T2* technique is a new tool to assess myocardial iron concentration that allows to tailor the optimal iron chelation treatment for each patient.</jats:p> <jats:p>Aim of the study: to assess left ventricular function and myocardial iron overload in a cohort of TM patients, cared at Hereditary Anemia Center in Milan, Italy.</jats:p> <jats:p>Methods and Results: In 91 TM patients (33 males/58 females, mean age 32 ± 6 yrs) myocardial iron loading was assessed with the use of CMR T2* measurements (CMR Tools, Cardiovascular Imaging Solutions, London, UK). Left ventricular ejection fraction (LVEF) was also assessed with CMR. In the overall group hemoglobin levels were 9.0 ± 1.0 g/dl; the mean serum ferritin levels and iron intake during the six months before CMR evaluation were 1507 ± 1884 ng/ml and 0.34 ± 0.08 mg/kg/die respectively. T2* was significantly different between females and males (24 ± 11 and 32 ± 12 ms, respectively; p &amp;lt; 0.0001), with significant differences in diabetes mellitus prevalence (17% vs 8%, p&amp;lt;0.01) but not in age, serum ferritin, iron intake and hemoglobin levels (Table 1). Seven (7.6%) asymptomatic females showed a severe cardiac iron overload (T2* ≤ 10 ms), 9 patients (9.9%) moderate (T2* between 10.1 and 14 ms), 15 patients (16.4%) mild cardiac iron overload (T2* between 14.1 and 20 ms) and 60 patients (65.9%) had normal T2* (&amp;gt; 20 ms). LVEF was significantly different between females and males (35% vs 57%, p&amp;lt;0.001) with evidence of a significant relationship between iron overload severity and LVEF impairment (r=0.92).</jats:p> <jats:p>Conclusions: CMR cardiac function and T2* assessment allow to detect pre-symptomatic cardiac iron overload. Females are more at risk for severe iron overload and left ventricular impairment. The prevalence of diabetes mellitus and compliance to chelation therapy could be relevant in explaining the gender differences.</jats:p> <jats:p>Clinical parameters and T2* values in men and women with thalassemia major Men p Women SD: standard deviation Number of patients (n. of pts) 33 - 58 Age ± SD (years) 33 ± 6 ns 32 ± 6 Hemoglobin levels ± SD (g/dl) 9.0 ± 1.7 ns 9.0 ± 0.8 Ferritin levels ± SD (ng/ml) 964 ± 891 ns 1821 ± 2216 Iron intake ± SD (mg/Kg/die) 0.30 ± 0.07 ns 0.36 ± 0.09 Mean T2* value ± SD (ms) 32 ± 12 &amp;lt;0.0001 24 ± 11 T2*&amp;lt; 10 ms (n. of pts) 0 - 7 T2* between 10.1 and 14 ms (n. of pts) 1 - 8 T2* between 14.1 and 20 ms (n. of pts) 7 - 8 T2* &amp;gt; 20 ms (n. of pts) 25 - 35 T2*&amp;lt; 10 ms (n. of pts) plus LVEF≤ 57 % 0/0 (0%) - 6/7 (85.7%) T2* between 10.1 and 14 ms (n. of pts) plus LVEF≤ 57 % 1/1 (100%) - 3/8 (37.5%) T2* between 14.1 and 20 ms (n. of pts) plus LVEF≤ 57 % 3/7 (42.8%) - 1/8 (12.5%) T2* &amp;gt; 20 ms (n. of pts) plus LVEF≤ 57 % 7/25 (28%) - 5/35 (14.3%)</jats:p> Gender Differences in Iron Overload and Left Ventricular Function in a Cohort of Thalassemia Major Patients: A Prospective Study of a Single Italian Center Using Cardiovascular Magnetic Resonance. Blood
spellingShingle Volpato, Elisabetta, Cassinerio, Elena, Fasulo, Maria Rosaria, Pedrotti, Paola, Pedretti, Stefano, Dellegrottaglie, Santo, Cappellini, Maria Domenica, Roghi, Alberto, Blood, Gender Differences in Iron Overload and Left Ventricular Function in a Cohort of Thalassemia Major Patients: A Prospective Study of a Single Italian Center Using Cardiovascular Magnetic Resonance., Cell Biology, Hematology, Immunology, Biochemistry
title Gender Differences in Iron Overload and Left Ventricular Function in a Cohort of Thalassemia Major Patients: A Prospective Study of a Single Italian Center Using Cardiovascular Magnetic Resonance.
title_full Gender Differences in Iron Overload and Left Ventricular Function in a Cohort of Thalassemia Major Patients: A Prospective Study of a Single Italian Center Using Cardiovascular Magnetic Resonance.
title_fullStr Gender Differences in Iron Overload and Left Ventricular Function in a Cohort of Thalassemia Major Patients: A Prospective Study of a Single Italian Center Using Cardiovascular Magnetic Resonance.
title_full_unstemmed Gender Differences in Iron Overload and Left Ventricular Function in a Cohort of Thalassemia Major Patients: A Prospective Study of a Single Italian Center Using Cardiovascular Magnetic Resonance.
title_short Gender Differences in Iron Overload and Left Ventricular Function in a Cohort of Thalassemia Major Patients: A Prospective Study of a Single Italian Center Using Cardiovascular Magnetic Resonance.
title_sort gender differences in iron overload and left ventricular function in a cohort of thalassemia major patients: a prospective study of a single italian center using cardiovascular magnetic resonance.
title_unstemmed Gender Differences in Iron Overload and Left Ventricular Function in a Cohort of Thalassemia Major Patients: A Prospective Study of a Single Italian Center Using Cardiovascular Magnetic Resonance.
topic Cell Biology, Hematology, Immunology, Biochemistry
url http://dx.doi.org/10.1182/blood.v110.11.3819.3819