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Assessment of Heart and Liver Iron Overload in Thalassemia Major Patients Using T2* Magnetic Resonance Imaging

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Abstract

Accumulation of excess iron in heart can lead to cardiac dysfunction, which is the most common cause of death in thalassemia major patients. Biopsy is an invasive procedure and therefore not an ideal option to assess iron load. However, standard/usual non-invasive methods, such as ferritin measurement, have some limitations and the results show poor correlations with iron load. Magnetic Response Imaging (MRI-T2*), as a non-invasive and reliable method for iron load assessment in organs such as liver and heart, can be suggested as a favorable alternative. This cross-sectional study was implemented in Thalassemia and Hemophilia Clinic Center (Sarvar) affiliated with Mashhad University of Medical Sciences, Mashhad, Iran, from 2012 to 2013. After the approval of the research protocol by the local ethic committee, laboratory tests, including CBC and serum ferritin, were carried out, and echocardiography and heart and liver MRI-T2* were performed. All statistical analysis was done through SPSS software (version 11.5), using independent sample t test and Pearson’s correlation coefficient test. A P value ≤0.05 was considered to be significant. 88 patients with the mean (±SD) age of 21.2 (±5.6) years, (range 11–37 years) were observed. Iron load was assessed using MRI-T2* with the following results: Out of 88 patients, 48.9 % had mild to severe cardiac siderosis, and 75.2 % had mild to severe liver siderosis. We demonstrated a correlation between liver MRI-T2* and serum ferritin, and heart MRI-T2* and ejection fraction. However, no correlation between liver and heart MRI-T2* was observed. Heart and liver siderosis is a common and serious problem in thalassemia major patients, and MRI-T2* as a sensitive and non-invasive technique can be used for early/timely detection of siderosis and good therapeutic monitoring in these patients.

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Acknowledgments

This study was extracted from a thesis by Dr. Saber Mohammadzadeh Rezaei, and would not have been possible without the encouragement and generous financial support of the Vice President of Research at Mashhad University of Medical Sciences. Hereby, we would like to express our heartfelt thanks to them and all those to whose kind assistance this study is indebted.

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Authors and Affiliations

  1. Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

    Hamid Farhangi, Zahra Badiei & Hasan Mottaghi Moghaddam

  2. Faculty of Medicine, Cancer Molecular Pathology Research Center, Emam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

    Mohammad Reza Keramati

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  1. Hamid Farhangi
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  2. Zahra Badiei
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  3. Hasan Mottaghi Moghaddam
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  4. Mohammad Reza Keramati
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Correspondence to Mohammad Reza Keramati.

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Farhangi, H., Badiei, Z., Moghaddam, H.M. et al. Assessment of Heart and Liver Iron Overload in Thalassemia Major Patients Using T2* Magnetic Resonance Imaging. Indian J Hematol Blood Transfus 33, 228–234 (2017). https://doi.org/10.1007/s12288-016-0696-5

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  • DOI: https://doi.org/10.1007/s12288-016-0696-5

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