Rapid Fire Abstracts
Antonella Meloni, PhD
Biomedical Engineer
Fondazione G. Monasterio CNR Regione Toscana, Italy
Antonella Meloni, PhD
Biomedical Engineer
Fondazione G. Monasterio CNR Regione Toscana, Italy
Laura Pistoia, MSc
Biologist
Fondazione Toscana Gabriele Monasterio, Italy
Giuseppe Peritore, MD
Radiologist
ARNAS Civico Benfratelli Di Cristina, Italy
Michela Zerbini, MD
Radiologist
Ospedale del Delta, Italy
Priscilla Fina, MD
Radiologist
Ospedale "Sandro Pertini", Italy
Luigi Barbuto
Radiologist
Azienda Ospedaliera di Rilievo Nazionale Antonio Cardarelli, Italy
Ada Riva, MD
Radiologist
Ospedale “SS. Annunziata” ASL Taranto, Italy
Domenico Visceglie, MD
Hematologist
Ospedale “Di Venere”, Italy
Vincenza Rossi, MD
Hematologist
Ospedale di Cosenza, Italy
Gaetano Roccamo
Hematologist
Ospedale "Civile", Italy
Vincenzo Positano, MSc
Biomedical Engineer
Fondazione Toscana Gabriele Monasterio, Italy
Filippo Cademartiri, MD, PhD
Radiologist
Fondazione Toscana Gabriele Monasterio, Italy
Despite the regular transfusion regimen, thalassemia represents a chronically anemic condition. The consequent cardiac remodeling is difficult to interpret. Thalassemia intermedia (TI) patients start transfusions later in life than thalassemia major (TM) patients and are subjected to prolonged periods of severe anemia. On the other side, cardiac size and function can be influenced also by eventually pre-existing iron overload, more pronounced in TM.
This multicenter cross-sectional study compared biventricular function parameters between adult regularly transfused TI and TM patients.
Methods:
We considered 135 adult regularly transfused TI patients (44.73±12.16 years, 77 females) and 135 age- and sex-matched TM patients (43.35±9.83 years, 77 females), consecutively enrolled in the Extension-Myocardial Iron Overload in Thalassemia Network.
Myocardial iron overload was quantified by multislice multiecho R2* technique. Biventricular function parameters were quantified in a standard way by cine images.
Results:
Table 1 shows the comparison of demographic, clinical, and CMR parameters between TI and TM patients. Age, sex, frequency of splenectomy and chelation, and serum ferritin levels were comparable between the two groups, but TI patients started regular transfusions significantly later and showed significantly lower pre-transfusion hemoglobin levels and cardiac R2* values.
In both patient groups, males exhibited significantly higher biventricular volumes and left ventricular (LV) mass indexed by body surface area and significantly lower biventricular ejection fractions. With the exception of the LV mass index, all biventricular function parameters were associated with the duration of the regular transfusions. No biventricular function parameter was associated with mean serum hemoglobin, mean serum ferritin or cardiac iron levels.
The end-diastolic volume index (EDVI) of both ventricles and the LV end-systolic volume index (ESVI) were significantly higher in TI than in TM patients. The ANCOVA correction for the duration of regular transfusions removed the disease-specific differences (LV EDVI: p=0.626; LV ESVI: p=0.288; right ventricular EDVI: p=0.951). The LV mass index was significantly higher in TI than in TM patients while the biventricular EF were comparable between the two groups.
Conclusion:
The increased lifetime exposure to more severe anemia is a strong determinant of the more pronounced biventricular dilatation of TI patients. Our data suggest the need to define “normal for regularly transfused TI” reference ranges to avoid a misdiagnosis of cardiac impairment.
