Left Ventricular Global Function Index is Associated with Myocardial Iron Overload and Heart Failure in Thalassemia Major Patients

Overview

Journal Int J Cardiovasc Imaging

Publisher Springer

Specialty Radiology

Date 2023 Jan 13

PMID 36637709

Authors

Antonella Meloni

Vincenzo Positano

Laura Pistoia

Riccardo Righi

Massimiliano Missere

Emanuele Grassedonio

Nicolo Schicchi

Antonino Vallone

Maria Rita Gamberini

Liana Cuccia

Roberto Lisi

Valerio Cecinati

Anna Spasiano

Filippo Cademartiri

Affiliations

Soon will be listed here.

Abstract

Purpose: The left ventricular global function index (LVGFI) is a comprehensive marker of cardiac performance, integrating LV morphology with global function. We explored the cross-sectional association of LVGFI with myocardial iron overload (MIO), LV ejection fraction (LVEF), myocardial fibrosis, and heart failure (HF) in β-thalassemia major (TM) patients.

Methods: We considered 1352 adult TM patients (708 females, 32.79 ± 7.16years) enrolled in the Myocardial Iron Overload in Thalassemia Network and 112 healthy subjects (50 females, 32.09 ± 6.08years). LVGFI and LVEF were assessed by cine images and MIO by multislice multiecho T2* technique. Replacement myocardial fibrosis was detected by late gadolinium enhancement technique.

Results: LVGFI and LVEF were significantly lower in patients with significant MIO (global heart T2*<20ms) than in patients without MIO and in healthy subjects but were comparable between TM patients without MIO and healthy subjects. In TM, LVGFI was significantly associated with LVEF (R = 0.733; p < 0.0001). Global heart T2* values were significantly associated with both LVGFI and LVEF, but the correlation with LVGFI was significantly stronger (p = 0.0001). Male sex, diabetes mellitus, significant MIO, and replacement myocardial fibrosis were the strongest predictors of LVGFI. Eighty-six patients had a history of HF and showed significantly lower global heart T2* values, LVEF, and LVGFI than HF-free patients. A LVGFI ≤ 44.9% predicted the presence of HF. The LVGFI showed a diagnostic performance superior to that of LVEF (area under the curve: 0.67 vs. 0.62; p = 0.039).

Conclusion: In TM patients the LVGFI correlates with MIO and provides incremental diagnostic value for HF detection compared with LVEF.

Citing Articles

Biatrial and Biventricular Reference Ranges Based on Cardiac Magnetic Resonance in Sickle Cell Disease Patients Without Heart Damage.

Pistoia L, Meloni A, Positano V, Quota A, Corigliano E, Messina G Diagnostics (Basel). 2025; 14(24.

PMID: 39767177 PMC: 11674925. DOI: 10.3390/diagnostics14242816.

Cardiovascular magnetic resonance in β-thalassemia major: beyond T2.

Meloni A, Saba L, Cademartiri F, Positano V, Pistoia L, Cau R Radiol Med. 2024; 129(12):1812-1822.

PMID: 39511065 DOI: 10.1007/s11547-024-01916-6.

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