ABSTRACT

Cardiac failure due to myocardial iron overload is the most common cause of death in beta-thalassemia patients. Multi/ two echo times-turbo field echo (TE-TFE) magnetic resonance imaging (MRI) is considered the gold standard technique in the evaluation of myocardial iron accumulation. However, multi TE-TFE technique is not available in all scanners. The aim of our study was to show the role of black blood dualecho cardiac triggered TFE in the assessment of myocardial iron overload.

Sixteen beta-thalassemia major patients (10 males) with a mean age of 19 years who were receiving parenteral deferoxamine and oral deferiprone treatment were included in this study. Baseline measurement of myocardial T2* values were <20 ms in all patients. Cardiac MRI was performed after 6 months, 12 months, and 18 months with the same technique.

The average baseline value of T2* was 8.2 ± 3.6 ms. After treatment of combined deferoxamine and deferiprone, the average measurements of myocardial T2* at 6, 12, and 18 months were 11.3 ± 6.0, 13.6 ± 7.5, and 15.7 ± 7.4 ms, respectively (P < 0.05). The basal ejection fraction (EF) value was 49 ± 8.7%. The EFs were 54.4 ± 11% at 6 months, 54.8 ± 6.9% at 12 months, and 58.6 ± 3.6% at 18 months of followup (P > 0.05).

Cardiac MRI with dual TE-TFE technique can be used to determine myocardial iron accumulation and response to the chelation treatment.

Keywords: beta-thalassemia, iron overload, myocardium, magnetic resonance imaging