Right ventricular volumes and function in thalassemia major patients in the absence of myocardial iron overloadReport as inadecuate




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Journal of Cardiovascular Magnetic Resonance

, 12:24

First Online: 23 April 2010Received: 16 February 2010Accepted: 23 April 2010

Abstract

AimWe aimed to define reference ranges for right ventricular RV volumes, ejection fraction EF in thalassemia major patients TM without myocardial iron overload.

Methods and resultsRV volumes, EF and mass were measured in 80 TM patients who had no myocardial iron overload myocardial T2* > 20 ms by cardiovascular magnetic resonance. All patients were receiving deferoxamine chelation and none had evidence of pulmonary hypertension or other cardiovascular comorbidity. Forty age and sex matched healthy non-anemic volunteers acted as controls. The mean RV EF was higher in TM patients than controls males 66.2 ± 4.1% vs 61.6 ± 6%, p = 0.0009; females 66.3 ± 5.1% vs 62.6 ± 6.4%, p = 0.017, which yielded a raised lower threshold of normality for RV EF in TM patients males 58.0% vs 50.0% and females 56.4% vs 50.1%. RV end-diastolic volume index was higher in male TM patients mean 98.1 ± 17.3 mL vs 88.4 ± 11.2 mL-m2, p = 0.027, with a higher upper limit 132 vs 110 mL-m2 but this difference was of borderline significance for females mean 86.5 ± 13.6 mL vs 80.3 ± 12.8 mL-m2, p = 0.09, with upper limit of 113 vs 105 mL-m2. The cardiac index was raised in TM patients males 4.8 ± 1.0 L-min vs 3.4 ± 0.7 L-min, p < 0.0001; females 4.5 ± 0.8 L-min vs 3.2 ± 0.8 L-min, p < 0.0001. No differences in RV mass index were identified.

ConclusionThe normal ranges for functional RV parameters in TM patients with no evidence of myocardial iron overload differ from healthy non-anemic controls. The new reference RV ranges are important for determining the functional effects of myocardial iron overload in TM patients.

List of abbreviationsBSA body surface area

CMR Cardiovascular magnetic resonance

ECG electrocardiograph

EF ejection fraction

FOV field of view

Hz Hertz

LV left ventricle

NHS National Health Service UK

RV right ventricle

RF radiofrequency

SD standard deviation

SSFP steady state free precession

T Tesla

TE echo time

TM thalassemia major

TR repetition time

T2* T2 star

UK United Kingdom

USA United States of America.

Electronic supplementary materialThe online version of this article doi:10.1186-1532-429X-12-24 contains supplementary material, which is available to authorized users.

John-Paul Carpenter, Francisco Alpendurada contributed equally to this work.

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Author: John-Paul Carpenter - Francisco Alpendurada - Monica Deac - Alicia Maceira - Maciej Garbowski - Paul Kirk - J Malcolm Walk

Source: https://link.springer.com/article/10.1186/1532-429X-12-24







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