HEART DISEASE AND PANCREATIC IRON IN THALASSEMIA MAJOR
Author(s): ,
Antonella Meloni
Affiliations:
Fondazione G. Monasterio CNR-Regione Toscana,Pisa,Italy
,
Laura Pistoia
Affiliations:
Fondazione G. Monasterio CNR-Regione Toscana,Pisa,Italy
,
Vincenzo Spadola
Affiliations:
Azienda Ospedaliera Civile - O.M.P.A. Ragusa,Ragusa,Italy
,
Mauro Murgia
Affiliations:
Ospedale San Martino di Oristano,Oristano,Italy
,
Alessandra Quota
Affiliations:
Ospedale 'V. Emanuele III',Gela,Italy
,
Valentina Carrai
Affiliations:
Azienda Ospedaliero - Universitaria Careggi,Firenze,Italy
,
Simona Bulgarelli
Affiliations:
Ospedale Bufalini,Cesena,Italy
,
Roberto Mattei
Affiliations:
A.U.L.S.S. 5 Polesani,Adria,Italy
,
Mehtap Pasin
Affiliations:
Ospedale 'Sandro Pertini',Roma,Italy
,
Leonardo Sardella
Affiliations:
A.S.L. di Bari - Ospedale “Di Venere”,Bari,Italy
,
Gennaro Restaino
Affiliations:
Fondazione di Ricerca e Cura 'Giovanni Paolo II',Campobasso,Italy
,
Paolo Preziosi
Affiliations:
Ospedale 'Sandro Pertini',Roma,Italy
,
Vincenzo Positano
Affiliations:
Fondazione G. Monasterio CNR-Regione Toscana,Pisa,Italy
Alessia Pepe
Affiliations:
Fondazione G. Monasterio CNR-Regione Toscana,Pisa,Italy
EHA Library. Meloni A. Jun 15, 2019; 267189; PS1572
Dr. Antonella Meloni
Dr. Antonella Meloni
Contributions
Abstract

Abstract: PS1572

Type: Poster Presentation

Presentation during EHA24: On Saturday, June 15, 2019 from 17:30 - 19:00

Location: Poster area

Background
Some preliminary data have postulated a correlation between pancreatic iron overload and heart iron and function in thalassemia major (TM) patients.

Aims

In the present multicenter study we explored systematically the link between pancreatic iron and heart disease in a large cohort of TM patients.

Methods

We considered 880 TM patients (467 M, mean age 37.83±10.05 years) enrolled in the E-MIOT (Extension-Myocardial Iron Overload in Thalassemia) project. T2* measurements were performed over pancreatic head, body and tail and global value was the mean. Myocardial iron overload (MIO) was quantified using a T2* segmental approach. Biventricular function parameters were assessed by cine images. Late gadolinium enhancement (LGE) images were acquired to detect myocardial fibrosis.

Results

A significant correlation between pancreatic and cardiac iron was reconfirmed in this more numerous population and a normal pancreas T2* showed negative predictive value of 100% for cardiac iron.

LGE sequences were acquired in 273 TM patients and 84 (30.77%) of them showed macroscopic myocardial fibrosis. Global pancreas T2* values were significantly lower in patients with fibrosis (7.38±6.19 ms vs 11.91±9.79 ms; P<0.0001).

Sixty-four patients had at least one cardiac complication (arrhythmias, heart failure, pulmonary hyperthension, vascular disease). Patients with cardiac complications showed a significant lower global pancreas T2* (7.83±5.61 ms vs 12.76±10.34 ms; P=0.024). Specifically, global pancreas T2* values were significantly lower in patients with heart failure as well as in patients with arrhythmias and all patients with one of these two diseases had a pathologic global pancreas T2* value (see Figure).

Conclusion

Pancreatic iron is a strong predictor not only for cardiac iron, but also for cardiac complications supporting a more profound link between pancreatic iron and heart disease in TM.

Session topic: 27. Thalassemias

Keyword(s): Complications, Iron overload, Magnetic resonance imaging

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