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Normalized left ventricular volumes and function in thalassemia major patients with normal myocardial iron
Author(s) -
Westwood Mark A.,
Anderson Lisa J.,
Maceira Alicia M.,
Shah Farrukh T.,
Prescott Emma,
Porter John B.,
Wonke Beatrix,
Walker J. Malcolm,
Pennell Dudley J.
Publication year - 2007
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.20915
Subject(s) - medicine , ejection fraction , cardiology , stroke volume , cardiac function curve , cardiomyopathy , body surface area , diastolic function , thalassemia , magnetic resonance imaging , nuclear medicine , diastole , heart failure , blood pressure , radiology
Purpose To determine the reference range in thalassemia major (TM) for left ventricular (LV) function. Materials and Methods We used cardiovascular magnetic resonance (CMR) to measure heart volumes and function in 81 TM patients with normal myocardial T2* measurements (T2* > 20 msec) and by inference without excess myocardial iron. Forty age‐ and gender‐matched healthy controls were also studied. Results Resting LV volumes and function normalized to body surface area differed significantly between TM patients and controls. The lower limit and the mean for ejection fraction (EF) were higher in TM patients (males 59 vs. 55%, mean 71% vs. 65%; females 63 vs. 59%, mean 71% vs. 67%; both P < 0.001). The upper limit and mean for end‐diastolic volume index were higher in TM patients (males 152 vs. 105 mL/m 2 , mean 97 vs. 84 mL/m 2 ; females 121 vs. 99 mL/m 2 , mean 87 vs. 79 mL/m 2 ; both P < 0.05). In TM patients the cardiac index ( P < 0.001) was increased. Conclusion At rest, TM patients with a normal myocardial T2* have different “normal” values for LV volume and function parameters compared to controls, and this has the potential to lead to a misdiagnosis of cardiomyopathy. We present new reference “normal” ranges in TM to alleviate this problem. J. Magn. Reson. Imaging 2007;25:1147–1151. © 2007 Wiley‐Liss, Inc.