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Correlation study between magnetic resonance imaging-quantitated cardiac iron deposition and left ventricular
Shuai Peng1,2, Fengming Xu1, Guangxin Yang1
1Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, People's Republic of China.
Insights
Cardiac iron deposition in beta-thalassemia major patients does not correlate with left ventricular function. Left ventricular ejection fraction is unreliable for predicting cardiac iron overload in this population.
Area of Science:
- Cardiology
- Hematology
- Radiology
Background:
- Transfusion-dependent beta-thalassemia major patients face risks of iron overload.
- Cardiac iron deposition can impair left ventricular function.
- Accurate assessment of cardiac iron is crucial for management.
Purpose of the Study:
- To investigate the correlation between cardiac iron levels and left ventricular function.
- To assess the predictive accuracy of left ventricular ejection fraction for cardiac iron deposition.
Main Methods:
- 150 transfusion-dependent beta-thalassemia major patients underwent MRI.
- Cardiac iron deposition was quantified using T2* values.
- Left ventricular function indicators (LVEDVI, LVESVI, LVEF) were measured.
Main Results:
- No linear correlation was found between cardiac R2* values and LVEDVI, LVESVI, or LVEF (P > 0.05).
- Sensitivity and specificity for LVEF predicting cardiac iron deposition were 83.3% and 63.2%, respectively.
- The area under the ROC curve for LVEF was 0.348, indicating poor predictive value.
Conclusions:
- Cardiac iron deposition is not linearly correlated with left ventricular function in beta-thalassemia major.
- Left ventricular ejection fraction is an unreliable index for predicting cardiac iron deposition in these patients.
- Clinical reliance on LVEF for assessing cardiac iron overload should be reconsidered.
Objective:
To explore the correlation between cardiac iron deposition and left ventricular function indicators, such as left ventricular end-diastolic volume index, left ventricular end-systolic volume index, and left ventricular ejection fraction, and to evaluate the accuracy of predicting patients with cardiac iron deposition by using left ventricular ejection fraction as an index.
Methods:
This quantitative cross-sectional study involved one hundred and fifty transfusion-dependent patients with β-thalassemia major who were evaluated by magnetic resonance imaging to obtain T2* values, left ventricular end-diastolic volume index, left ventricular end-systolic volume index, and left ventricular ejection fraction. The relationship between cardiac R2* values and left ventricular end-diastolic volume index, left ventricular end-systolic volume index, and left ventricular ejection fraction was analyzed.
Results:
Out of the 150 patients, cardiac iron overload was not observed for 92 patients, 42 patients exhibited mild to moderate cardiac iron overload, and 16 patients were severe cardiac iron overloaded. A linear correlation was not observed between the cardiac R2* values and left ventricular end-diastolic volume index, left ventricular end-systolic volume index, and left ventricular ejection fraction (P > 0.05). For the left ventricular ejection fraction index, the sensibility, specificity, positive predictive value, negative predictive value, and the agreement rate were 83.3%, 63.2%, 8.6%, 98.9%, and 64.0%, respectively; also, the area under the receiver operating characteristic curve was 0.348.
Conclusions:
A linear correlation was not observed between cardiac R2* values and left ventricular end-diastolic volume index, left ventricular end-systolic volume index, and left ventricular ejection fraction in patients with β-thalassemia major. Therefore, using left ventricular ejection fraction as an indirect index to predict cardiac iron deposition may be not reliable in clinical practice.
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