RSNA 2012 

Abstract Archives of the RSNA, 2012


LL-CAS-TU5D

Thalassemia Major (TM) and Right Heart Involvement: A Cardiac MR (CMR) Evaluation

Scientific Informal (Poster) Presentations

Presented on November 27, 2012
Presented as part of LL-CAS-TUPM: Cardiac Afternoon CME Posters  

Participants

Carlo Liguori, Presenter: Nothing to Disclose
Ilenia Di Giampietro, Abstract Co-Author: Nothing to Disclose
Francesca Pitocco, Abstract Co-Author: Nothing to Disclose
Aldo Eros De Vivo, Abstract Co-Author: Nothing to Disclose
Paolo Cianciulli MD, Abstract Co-Author: Nothing to Disclose
Bruno Beomonte Zobel MD, Abstract Co-Author: Nothing to Disclose

PURPOSE

It is well known that Right Heart involvement in patients with TM can be caused by right ventricle (RV) insufficiency due to chronic anaemia while iron deposition affects mainly left ventricle. It is still unclear if the RV can be affected by iron overload and if RV ejection fraction (EF) and volumes can be influenced by myocardial iron deposition. We aimed to define normal ranges for RV volumes and EF in a setting of thalassemia major patients without myocardial iron overload compared to a large cohort of TM subjects free from siderosis

METHOD AND MATERIALS

RV-EF, Volumes and Mass index were measured in 150 patients (mean age 36,7± 12,7 ys); 15% had myocardial iron overload (myocardial T2* < 20 ms measured by CMR). All patients were under iron chelation therapy and none had clinical or instrumental signs of right heart disfunction

RESULTS

The mean RVEF was lower in patients with iron overload than others (55,6±6% vs 68,2±3%, p <0,01) with no differences between sex. RV Stroke, end-diastolic and end-systolic volume index was slightly lower in patients with siderosis (38, 46, 85 vs 44, 31, 79 ml/m2, p < 0,01). Right ventricle mass index showed no significant difference between the two categories (38,6 +/- 5 vs 36 +/- 6 g/m2)

CONCLUSION

Right Heart myocardium can be affected by iron deposits as well as left chambers with consequential functional impairment and volumetric enlargement of the right ventricle. This data must be kept in mind carefully in the evaluation of TM patients for a correct evaluation of heart condition

CLINICAL RELEVANCE/APPLICATION

Study shows the presence of RV alterations in a large cohort of TM patients with iron overload demonstrating the effect of myocardial siderosis in the right ventricle

Cite This Abstract

Liguori, C, Di Giampietro, I, Pitocco, F, De Vivo, A, Cianciulli, P, Beomonte Zobel, B, Thalassemia Major (TM) and Right Heart Involvement: A Cardiac MR (CMR) Evaluation.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12043672.html