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Prospective Assessment of Cardiac Iron Deposition, Morphology, and Function by Magnetic Resonance Imaging in

Antonella Meloni1, Laura Pistoia2, Filomena Longo3

  • 1Bioengineering Unit, Fondazione G. Monasterio CNR-Regione Toscana, 56124 Pisa, Italy.

Journal of Clinical Medicine
|June 26, 2025
PubMed

Insights

Non-transfusion-dependent thalassemia (NTDT) patients showed progressive ventricular dilation, unlike neo-transfusion-dependent thalassemia (neo-TDT) patients, over 18 months. This highlights the need for cardiac monitoring in NTDT to manage long-term anemia complications.

Area of Science:

  • Cardiology
  • Hematology
  • Medical Imaging

Background:

  • Thalassemia is a group of inherited blood disorders characterized by reduced hemoglobin production.
  • Iron overload is a common complication in thalassemia patients, particularly those receiving regular blood transfusions.
  • Magnetic resonance imaging (MRI) is a key tool for assessing iron levels and cardiac function in these patients.

Purpose of the Study:

  • To compare cardiac and hepatic iron levels, biventricular dimensions and function, and bi-atrial areas using MRI over 18 months.
  • To differentiate cardiac remodeling patterns between non-transfusion-dependent thalassemia (NTDT) and neo-transfusion-dependent thalassemia (neo-TDT) patients.
  • To identify potential long-term cardiac consequences in NTDT patients.

Main Methods:

  • An 18-month longitudinal study comparing 32 NTDT and 58 neo-TDT patients.
  • Cardiac and hepatic iron levels quantified using T2* MRI technique.
  • Biventricular function, dimensions, and atrial areas assessed via cine MRI.
  • Myocardial fibrosis detected using late gadolinium enhancement MRI.

Main Results:

  • Changes in iron levels, ejection fractions, LV mass index, and atrial areas were similar between NTDT and neo-TDT groups.
  • NTDT patients showed a trend of worsening biventricular dimensions, while neo-TDT patients exhibited improvement.
  • Significant differences were observed in the changes of biventricular end-diastolic and stroke volume indexes, and cardiac index between the groups.
  • Myocardial fibrosis frequency was comparable in both groups at both MRI scans.

Conclusions:

  • Distinct cardiac remodeling patterns exist between NTDT and neo-TDT patients over 18 months.
  • Progressive ventricular dilation in NTDT patients necessitates careful MRI monitoring.
  • Interventions may be required to address the long-term cardiac effects of anemia in NTDT patients.

Keywords:
cardiac sizeiron overloadmagnetic resonance imagingneo-transfusion-dependent thalassemianon-transfusion dependent thalassemia

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