Correlation Between T2* Cardiovascular Magnetic Resonance with Left Ventricular Function and Mass in Adolescent and Adult Major Thalassemia Patients with Iron Overload

ABSTRACT: to assess for a correlation between T2*CMR with LV function and mass in thalassemic patients with iron overload. Methods: a cross-sectional study on thalassemic patients was conducted between July and September 2010 at Cipto Mangunkusumo and Premier Hospitals, Jakarta, Indonesia. Clinical examinations, review of medical charts, electrocardiography, echocardiography, and T2*CMR were performed. Cardiac siderosis was measured by T2*CMR conduction time. Left ventricle diastolic and systolic functions, as well as LV mass index were measured using echocardiography. Correlations between T2*CMR and echocardiography fndings, as well as serum ferritin were determined using Pearson’s and Spearman’s tests. Results: thirty patients aged 13-41 years were enrolled, of whom two-thirds had β-thalassemia major and one-third had HbE/β-thalassemia. Diastolic dysfunction was identifed in 8 patients, whereas systolic function was normal in all patients. Increased LV mass index was found in 3 patients. T2*CMR conduction times ranged from 8.98 to 55.04 ms and a value below 20 ms was demonstrated in 14 patients. There was a statistically signifcant moderate positive correlation of T2*CMR conduction time with E/A ratio (r = 0.471, P = 0.009), but no correlation was found with LV mass index (r=0.097, P=0.608). A moderate negative correlation was found between T2*CMR and serum ferritin (r = -0.514, P = 0.004), while a moderate negative correlation was found between serum ferritin and E/A ratio (r = -0.425, P = 0.019). Conclusion: T2*CMR myocardial conduction time has a moderate positive correlation with diastolic function, moderate negative correlation with serum ferritin, but not with LV mass index and systolic function.
Key words: T2* cardiovascular magnetic resonance, diastolic dysfunction, iron overload, thalassemia major
Author: Mulyadi M. Djer, Shirley L. Anggriawan, Djajadiman Gatot, Pustika Amalia, Sudigdo Sastroasmoro, Patricia Widjaja
Journal Code: jpkedokterangg130274

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