Cardiac Iron Determines Cardiac T2*, T2, and T1 in the Gerbil Model of Iron Cardiomyopathy

Wood, John C.; Otto‐Duessel, Maya; Aguilar, Michelle; Nick, Hanspeter; Nelson, Marvin D.; Coates, Thomas D.; Pollack, Harvey; Moats, Rex

doi:10.1161/circulationaha.104.504415

Cited by 216 publications

(230 citation statements)

References 43 publications

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“…T2* is significantly affected by the magnetic field perturbation caused by particulate iron in the myocardium and therefore T2* falls as the amount of iron increases. These findings which have been confirmed in an animal model of iron overload [8]. The normal human T2* value (measured in milliseconds) is greater than 20 ms.…”

supporting

confidence: 54%

Cardiopulmonary exercise testing in thalassemia

Carpenter

Pennell

2009

Int J Cardiovasc Imaging

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supporting

confidence: 54%

Cardiopulmonary exercise testing in thalassemia

Carpenter

Pennell

2009

Int J Cardiovasc Imaging

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“…A number of studies have demonstrated that by measurement of T2* relaxation time MRI may also be eligible to measure iron overload in the heart, the most critical organ in this respect [28,34,35]. Deferasirox is assumed to be inferior to deferoxamine and deferiprone for the removal of excess cardiac iron [36][37][38], but there are no comparative data that exist in this regard.…”

Section: Discussionmentioning

confidence: 99%

“…An LIC >35-µmol/g liver tissue was considered as iron overload. The changes in myocardial siderosis were quantified by myocardial T2* MRI [27,28]. The lower the T2* value in milliseconds (ms), the greater the myocardial iron load (normal value >35 ms; pathologic <25 ms, standard deviation ±20) [29,30].…”

Section: Methodsmentioning

confidence: 99%

Deferasirox in MDS patients with transfusion-caused iron overload—a phase-II study

et al. 2008

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International audienceBlood transfusions represent a main component of supportive care in myelodysplastic syndromes (MDS). To avoid organ damage caused by transfusion-dependent iron overload, an adequate iron chelation therapy is required. Recently, a new oral iron chelator deferasirox (ICL670, Exjade®) has become available. A study was conducted to demonstrate the efficacy and tolerability of deferasirox in transfusion-dependent iron-overloaded patients with MDS. The efficacy of deferasirox was monitored by changes in serum ferritin, bone marrow iron, and liver iron concentration (LIC), as determined by T2*-weighted magnetic resonance imaging. Twelve patients with MDS of different subtypes (median age 76 years, range 53–91) were enrolled. Deferasirox administered in a once-daily dose of 20–30 mg/kg for 12 months was effective in reducing median ferritin concentration from 1,515 µg/L (range 665–6,900) to 413 µg/L (range 105–3,052). Within the first 4 weeks of treatment before the continuous decline of ferritin levels, the values markedly rose in eight of 12 patients. The median LIC declined from 315 to 230 µmol/g ( = 0.02) at the end of study, accompanied by a reduction of bone marrow siderosis. The most common adverse events were mild and transient gastrointestinal disturbances, skin rash, nonprogressive transient increases in serum creatinine and urine β2-microglobulin, and a temporary reduction of the creatinine clearance. The renal parameters normalized after end of treatment. No hematologic toxicities were observed. Deferasirox proved to be effective in transfusion-dependent iron overload in MDS by mobilizing iron deposits in liver and at least stabilizing iron stores in bone marrow

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“…A study showed that patients with T2* > 20 msec (no detectable cardiac iron) do not typically develop heart dysfunction, while patients with T2* < 10 msec are at a proportionally higher risk for cardiac dysfunction [19]. R2* exhibits a linear relationship to heart iron according to data from animal studies [20]. In addition, although storage patterns of iron in the heart and in the liver were different, the MRI calibration for an R2* technique does not differ significantly [20].…”

Section: Liver Biopsymentioning

confidence: 99%

Diagnosis and management of transfusion iron overload: The role of imaging

Wood

2007

Am. J. Hematol.

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The characterization of iron stores is important to prevent and treat iron overload. Serum markers such as ferritin, serum iron, iron binding capacity, transferrin saturation, and nontransferrin‐bound iron can be used to follow trends in iron status; however, variability in these markers limits predictive power for any given individual. Liver iron represents the best single marker of total iron balance. Measures of liver iron include biopsy, superconducting quantum interference device, computer tomography, and magnetic resonance imaging (MRI). MRI is the most accurate and widely available noninvasive tool to assess liver iron. The main advantages of MRI include a low‐rate of variability between measurements and the ability to assess iron loading in endocrine tissues, the heart and the liver. This manuscript describes the principles, validation, and clinical utility of MRI for tissue iron estimation. Am. J. Hematol., 2007. © 2007 Wiley‐Liss, Inc.

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Cardiac Iron Determines Cardiac T2*, T2, and T1 in the Gerbil Model of Iron Cardiomyopathy

Cited by 216 publications

References 43 publications

Cardiopulmonary exercise testing in thalassemia

Cardiopulmonary exercise testing in thalassemia

Deferasirox in MDS patients with transfusion-caused iron overload—a phase-II study

Diagnosis and management of transfusion iron overload: The role of imaging

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