Abstract
Twenty-five thalassaemic patients treated with repeated blood transfusion (BT) and intensive iron removal therapy were studied by echocardiography and rest/stress equilibrium gated radionuclide angiocardiography (EGNA). Stress left ventricular ejection fraction (LVEF) showed an important negative correlation with number of BTs (r = −0.75). Abnormal values of stress LVEF were measured after 200 BTs: these data demonstrate the effectiveness of stress LVEF in the follow-up of patients who have undergone repeated BTs and the clinical importance of intensive chelation therapy. Peak filling rate did not show diagnostic value in the early detection of iron cardiotoxicity. However, its inverse correlation with BT (r = −60) indicates that iron overload depresses the diastolic parameters.
Similar content being viewed by others
References
Engle ME, Erlandson M, Smith CH. Late cardiac complications of chronic, severe, refractory anemia with hemocromatosis. Circulation 1964; 30:698–703.
Nienhuis AW, Griffith P, Strawezynski H, Henry W, Borer J, Leon M, Anderson WF. Evaluation of cardiac function in patients with thalassemia major. Ann NY Acad Sci 1980; 344:377–396.
Enlers K, Levin AR, Makerson AL, Marcus JR, Klein AA, Hilgarten MW, Engle MA. Longitudinal study of cardiac function in thalassemia major. Ann NY Acad Sci 1980; 344:397–404.
Leon MB, Borer JS, Bacharach SL, Green MS, Benz EJ, Griffith RN, Nienhuis A. Detection of early cardiac dysfunction in patients with severe beta-thalassemia and chronic iron overload. N Engl J Med 1979; 22:1143–1148.
Lewis BS, Rachmilewitz EA, Amitasi N, Halon DA, Gotsman MS. Left ventricular function in beta-thalassemia and the effect of multiple transfusions. Am Heart J 1978; 96:636–645.
Zurlo MG, De Stefano P, Borgna-Pignatti C, Di Palma A, Melevendi C, Di Gregorio F, Burattini MG, Terzoli S. Survival and causes of death in thalassaemia major. Lancet 1989; 11:27–30.
Marcus RE, Davies SC, Bantock HM, Underwood SR, Walton S, Huchns ER. Desferrioxamine to improve cardiac function in iron-overloaded patients with thalassaemia major. Lancet 1984; I:392–393.
Freeman AP, Giles RW, Berdoukas V, Walsh WF, Chay D, Murray PC. Early left ventricular dysfunction and chelation therapy in thalassemia. Ann Intern Med 1983; 99:450–454.
Wolfe L, Olivieri N, Sallan D, Colan S, Rose V, Propper R, Freedman MH, Nathan DG. Prevention of cardiac disease by subcutaneous desferrioxamine in patients with thalassemia major. N Engl J Med 1985; 312:1600–1603.
Model B, Berdoukas V. The clinical approach to thalassemia. London: Grune & Stratton 1984.
Marni E, Borgna-Pignatti C, De Stefano P, Dell'Acqua S, Noe GP, Barzina F, Grandi A, Venco A. Evaluation of cardiac status in thalassaemia major: a study of 32 patients. Hematologica 1983; 68:517–522.
Auriacombe L, Idi D, Le Bidois J, et al. Function cardiaque et depots ferriques dans la talassémie: etude prospective avec biopsies endomyocardiques. Giornale Italiano di Cardiologia 1990; 20 Suppl 2:37.
Friedman BJ, Drinkovic N, Miles H, et al. Assessment of left ventricular diastolic function: comparison of Doppler echocardiography and gated blood pool scintigraphy. J Am Coll Cardiol 1986; 8:1348–1354.
Cao A, Gabutti V, Masera G, Modell B, Sirchia G, Vullo C. A short guide to the management of thalassemia. In: Sirchia G, Zanella A, eds. Thalassemia today. The Mediterranean experience. Milan: Ospedale Maggiore Editore; 1987:636–676.
Teichholtz LE, Kreulen T, Herman MW, Gorlin R (1976) Problems in echocardiographic volume determinations: echocardiographic angiographic correlations in the presence or absence of asynergy. Am J Cardiol 1976; 37:7311.
Polak JF, Kemper AJ, Bianco JA, Parisi AF, Tow D. Resting early peak diastolic filling rate: a sensitive index of myocardial dysfunction in patients with coronary artery disease. J Nucl Med 1982; 23:471–478.
Bachrach SL, Green MV, Borer JS, Hyde JE, Farkas SP, Johnston GG. Left-ventricular peak ejection rate, filling rate, and ejection fraction. Frame rate requirement of rest and exercise. J Nucl Med 1979; 20:189–193.
Spirito P, Lupi G. Melevendi C, Vecchio C. Restrictive diastolic abnormalities identified by Doppler echocardiography in patients with thalassemia major. Circulation 1990; 82:88–94.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Scopinaro, F., Banci, M., Vania, A. et al. Radioisotope assessment of heart damage in hypertransfused thalassaemic patients. Eur J Nucl Med 20, 603–608 (1993). https://doi.org/10.1007/BF00176555
Received:
Revised:
Issue Date:
DOI: https://doi.org/10.1007/BF00176555