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Cardiac iron measurement and iron chelation therapy in patients with β thalassaemia major: experience from Taiwan

Authors


Correspondence: Prof. Kai-Hsin Lin, Department of Pediatrics, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.

Tel.: 886 2 23123456 ext 71526; fax: 886 2 23147450; e-mail: khlin2@ntu.edu.tw

Summary

Background

The aims of our study were to evaluate (i) the relationship between cardiac T2* values and cardiac complications in Asian β-thalassaemia major (TM) patients, and (ii) the association between cardiac T2* values and other parameters currently used to predict cardiac complications as a result of transfusion iron overload.

Methods

We examined the myocardial iron loads of 88 TM patients from Taiwan with cardiac T2* magnetic resonance imaging (MRI) and assessed the correlation between cardiac T2* values and serum ferritin levels, liver iron concentration and left ventricular ejection fraction (LVEF). We also determined the predictive value of these measurements for the development of arrhythmia.

Results and conclusion

In our group of Taiwanese patients, the relative risk for arrhythmia was 10·36 when cardiac T2* values were less than 10 ms (compared with ≥10 ms) and 1·98 when serum ferritin levels increased >2500 ng mL−1 (compared with ≤2500 ng mL−1). Serum ferritin levels correlated with cardiac T2* values in patients with abnormal myocardial iron loads (T2* < 20 ms, r = −0·48, P = 0·004, n = 34), but LVEF (measured by echocardiography) gave no indication of excess myocardial iron deposition (r = −0·07, P = 0·52) or of the risk of developing arrhythmia.

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