Left ventricular global function index is associated with myocardial iron overload and heart failure in thalassemia major patients
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, an...
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| Veröffentlicht in: | The international journal of cardiovascular imaging 2023-05, Vol.39 (5), p.991-999 |
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| creator | Meloni, Antonella Positano, Vincenzo Pistoia, Laura Righi, Riccardo Missere, Massimiliano Grassedonio, Emanuele Schicchi, Nicolò Vallone, Antonino Gamberini, Maria Rita Cuccia, Liana Lisi, Roberto Cecinati, Valerio Spasiano, Anna Cademartiri, Filippo |
| description | 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* |
| doi_str_mv | 10.1007/s10554-023-02792-3 |
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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.</description><identifier>ISSN: 1875-8312</identifier><identifier>ISSN: 1569-5794</identifier><identifier>EISSN: 1875-8312</identifier><identifier>EISSN: 1573-0743</identifier><identifier>DOI: 10.1007/s10554-023-02792-3</identifier><identifier>PMID: 36637709</identifier><language>eng</language><publisher>Dordrecht: Springer Netherlands</publisher><subject>Adult ; beta-Thalassemia - complications ; beta-Thalassemia - diagnosis ; Blood diseases ; Cardiac Imaging ; Cardiology ; Cardiomyopathies ; Congestive heart failure ; Contrast Media ; Cross-Sectional Studies ; Diabetes mellitus ; Diagnostic systems ; Female ; Females ; Fibrosis ; Gadolinium ; Heart failure ; Heart Failure - complications ; Heart Failure - etiology ; Humans ; Imaging ; Iron ; Iron Overload - diagnostic imaging ; Iron Overload - etiology ; Magnetic Resonance Imaging - methods ; Male ; Medicine ; Medicine & Public Health ; Original Paper ; Overloading ; Predictive Value of Tests ; Radiology ; Thalassemia ; Ventricle ; Ventricular Function, Left</subject><ispartof>The international journal of cardiovascular imaging, 2023-05, Vol.39 (5), p.991-999</ispartof><rights>The Author(s), under exclusive licence to Springer Nature B.V. 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to Springer Nature B.V.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c419t-ba0c220a4e2d7a21d6c196418e3b2114e0fcefdf1346760c6daaef8f2a78f3f93</citedby><cites>FETCH-LOGICAL-c419t-ba0c220a4e2d7a21d6c196418e3b2114e0fcefdf1346760c6daaef8f2a78f3f93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10554-023-02792-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10554-023-02792-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36637709$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Meloni, Antonella</creatorcontrib><creatorcontrib>Positano, Vincenzo</creatorcontrib><creatorcontrib>Pistoia, Laura</creatorcontrib><creatorcontrib>Righi, Riccardo</creatorcontrib><creatorcontrib>Missere, Massimiliano</creatorcontrib><creatorcontrib>Grassedonio, Emanuele</creatorcontrib><creatorcontrib>Schicchi, Nicolò</creatorcontrib><creatorcontrib>Vallone, Antonino</creatorcontrib><creatorcontrib>Gamberini, Maria Rita</creatorcontrib><creatorcontrib>Cuccia, Liana</creatorcontrib><creatorcontrib>Lisi, Roberto</creatorcontrib><creatorcontrib>Cecinati, Valerio</creatorcontrib><creatorcontrib>Spasiano, Anna</creatorcontrib><creatorcontrib>Cademartiri, Filippo</creatorcontrib><title>Left ventricular global function index is associated with myocardial iron overload and heart failure in thalassemia major patients</title><title>The international journal of cardiovascular imaging</title><addtitle>Int J Cardiovasc Imaging</addtitle><addtitle>Int J Cardiovasc Imaging</addtitle><description>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.</description><subject>Adult</subject><subject>beta-Thalassemia - complications</subject><subject>beta-Thalassemia - diagnosis</subject><subject>Blood diseases</subject><subject>Cardiac Imaging</subject><subject>Cardiology</subject><subject>Cardiomyopathies</subject><subject>Congestive heart failure</subject><subject>Contrast Media</subject><subject>Cross-Sectional Studies</subject><subject>Diabetes mellitus</subject><subject>Diagnostic systems</subject><subject>Female</subject><subject>Females</subject><subject>Fibrosis</subject><subject>Gadolinium</subject><subject>Heart failure</subject><subject>Heart Failure - complications</subject><subject>Heart Failure - etiology</subject><subject>Humans</subject><subject>Imaging</subject><subject>Iron</subject><subject>Iron Overload - diagnostic imaging</subject><subject>Iron Overload - etiology</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Paper</subject><subject>Overloading</subject><subject>Predictive Value of Tests</subject><subject>Radiology</subject><subject>Thalassemia</subject><subject>Ventricle</subject><subject>Ventricular Function, Left</subject><issn>1875-8312</issn><issn>1569-5794</issn><issn>1875-8312</issn><issn>1573-0743</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kT1vFDEQhlcIRELgD1BElmhoFvyxa69LFIUP6SSaUFtz9jjnk3d9sb2BtPxyHC58iILCGkvzzDsjPV33ktE3jFL1tjA6jkNPuWhPad6LR90pm9TYT4Lxx3_9T7pnpewpZUpo_bQ7EVIKpag-7b5v0Fdyi0vNwa4RMrmOaQuR-HWxNaSFhMXhNxIKgVKSDVDRka-h7sh8lyxkFxoccgPTLeaYwBFYHNkh5Eo8hLhmbBmk7iC2BJwDkBn2KZMD1ND2lufdEw-x4IuHetZ9eX95dfGx33z-8Oni3aa3A9O13wK1nFMYkDsFnDlpmZYDm1BsOWMDUm_RO8_EIJWkVjoA9JPnoCYvvBZn3etj7iGnmxVLNXMoFmOEBdNaDFdyVGqUE2_oq3_QfVrz0q4zfKKaazEo1ih-pGxOpWT05pDDDPnOMGruDZmjIdMMmZ-GjGhD5w_R63ZG93vkl5IGiCNQWmu5xvxn939ifwBPh56F</recordid><startdate>20230501</startdate><enddate>20230501</enddate><creator>Meloni, Antonella</creator><creator>Positano, Vincenzo</creator><creator>Pistoia, Laura</creator><creator>Righi, Riccardo</creator><creator>Missere, Massimiliano</creator><creator>Grassedonio, Emanuele</creator><creator>Schicchi, Nicolò</creator><creator>Vallone, Antonino</creator><creator>Gamberini, Maria Rita</creator><creator>Cuccia, Liana</creator><creator>Lisi, Roberto</creator><creator>Cecinati, Valerio</creator><creator>Spasiano, Anna</creator><creator>Cademartiri, Filippo</creator><general>Springer Netherlands</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20230501</creationdate><title>Left ventricular global function index is associated with myocardial iron overload and heart failure in thalassemia major patients</title><author>Meloni, Antonella ; Positano, Vincenzo ; Pistoia, Laura ; Righi, Riccardo ; Missere, Massimiliano ; Grassedonio, Emanuele ; Schicchi, Nicolò ; Vallone, Antonino ; Gamberini, Maria Rita ; Cuccia, Liana ; Lisi, Roberto ; Cecinati, Valerio ; Spasiano, Anna ; Cademartiri, Filippo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c419t-ba0c220a4e2d7a21d6c196418e3b2114e0fcefdf1346760c6daaef8f2a78f3f93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adult</topic><topic>beta-Thalassemia - complications</topic><topic>beta-Thalassemia - diagnosis</topic><topic>Blood diseases</topic><topic>Cardiac Imaging</topic><topic>Cardiology</topic><topic>Cardiomyopathies</topic><topic>Congestive heart failure</topic><topic>Contrast Media</topic><topic>Cross-Sectional Studies</topic><topic>Diabetes mellitus</topic><topic>Diagnostic systems</topic><topic>Female</topic><topic>Females</topic><topic>Fibrosis</topic><topic>Gadolinium</topic><topic>Heart failure</topic><topic>Heart Failure - complications</topic><topic>Heart Failure - etiology</topic><topic>Humans</topic><topic>Imaging</topic><topic>Iron</topic><topic>Iron Overload - diagnostic imaging</topic><topic>Iron Overload - etiology</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Paper</topic><topic>Overloading</topic><topic>Predictive Value of Tests</topic><topic>Radiology</topic><topic>Thalassemia</topic><topic>Ventricle</topic><topic>Ventricular Function, Left</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Meloni, Antonella</creatorcontrib><creatorcontrib>Positano, Vincenzo</creatorcontrib><creatorcontrib>Pistoia, Laura</creatorcontrib><creatorcontrib>Righi, Riccardo</creatorcontrib><creatorcontrib>Missere, Massimiliano</creatorcontrib><creatorcontrib>Grassedonio, Emanuele</creatorcontrib><creatorcontrib>Schicchi, Nicolò</creatorcontrib><creatorcontrib>Vallone, Antonino</creatorcontrib><creatorcontrib>Gamberini, Maria Rita</creatorcontrib><creatorcontrib>Cuccia, Liana</creatorcontrib><creatorcontrib>Lisi, Roberto</creatorcontrib><creatorcontrib>Cecinati, Valerio</creatorcontrib><creatorcontrib>Spasiano, Anna</creatorcontrib><creatorcontrib>Cademartiri, Filippo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>The international journal of cardiovascular imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Meloni, Antonella</au><au>Positano, Vincenzo</au><au>Pistoia, Laura</au><au>Righi, Riccardo</au><au>Missere, Massimiliano</au><au>Grassedonio, Emanuele</au><au>Schicchi, Nicolò</au><au>Vallone, Antonino</au><au>Gamberini, Maria Rita</au><au>Cuccia, Liana</au><au>Lisi, Roberto</au><au>Cecinati, Valerio</au><au>Spasiano, Anna</au><au>Cademartiri, Filippo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Left ventricular global function index is associated with myocardial iron overload and heart failure in thalassemia major patients</atitle><jtitle>The international journal of cardiovascular imaging</jtitle><stitle>Int J Cardiovasc Imaging</stitle><addtitle>Int J Cardiovasc Imaging</addtitle><date>2023-05-01</date><risdate>2023</risdate><volume>39</volume><issue>5</issue><spage>991</spage><epage>999</epage><pages>991-999</pages><issn>1875-8312</issn><issn>1569-5794</issn><eissn>1875-8312</eissn><eissn>1573-0743</eissn><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.</abstract><cop>Dordrecht</cop><pub>Springer Netherlands</pub><pmid>36637709</pmid><doi>10.1007/s10554-023-02792-3</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult beta-Thalassemia - complications beta-Thalassemia - diagnosis Blood diseases Cardiac Imaging Cardiology Cardiomyopathies Congestive heart failure Contrast Media Cross-Sectional Studies Diabetes mellitus Diagnostic systems Female Females Fibrosis Gadolinium Heart failure Heart Failure - complications Heart Failure - etiology Humans Imaging Iron Iron Overload - diagnostic imaging Iron Overload - etiology Magnetic Resonance Imaging - methods Male Medicine Medicine & Public Health Original Paper Overloading Predictive Value of Tests Radiology Thalassemia Ventricle Ventricular Function, Left |
| title | Left ventricular global function index is associated with myocardial iron overload and heart failure in thalassemia major patients |
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