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Home > Archive > Pathology > October 2004 > Siderotic heart failure is often reversible
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Siderotic heart failure is often reversible
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| Br J Haematol. 2004 Nov;127(3):348-55. Links
Myocardial iron clearance during reversal of siderotic cardiomyopathy with
intravenous desferrioxamine: a prospective study using T2* cardiovascular
magnetic resonance.
Anderson LJ, Westwood MA, Holden S, Davis B, Prescott E, Wonke B, Porter JB,
Malcolm Walker J, Pennell DJ.
Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, London.
Summary Heart failure from iron overload causes 71% of deaths in thalassaemia
major, yet reversal of siderotic cardiomyopathy has been reported. In order to
determine the changes in myocardial iron during treatment, we prospectively
followed thalassaemia patients commencing intravenous desferrioxamine for
iron-induced cardiomyopathy during a 12-month period. Cardiovascular magnetic
resonance assessments were performed at baseline, 3, 6 and 12 months of
treatment, and included left ventricular (LV) function and myocardial and liver
T2*, which is inversely related to iron concentration. One patient died. The
six survivors showed progressive improvements in myocardial T2* (5.1 +/- 1.9 to
8.1 +/- 2.8 ms, P = 0.003), liver iron (9.6 +/- 4.3 to 2.1 +/- 1.5 mg/g, P =
0.001), LV ejection fraction (52 +/- 7.1% to 63 +/- 6.4%, P = 0.03), LV volumes
(end diastolic volume index 115 +/- 17 to 96 +/- 3 ml, P = 0.03; end systolic
volume index 55 +/- 16 to 36 +/- 6 ml, P = 0.01) and LV mass index (106 +/- 14
to 95 +/- 13, P = 0.01). Iron cleared more slowly from myocardium than liver
(5.0 +/- 3.3% vs. 39 +/- 23% per month, P = 0.02). These prospective data
confirm that siderotic heart failure is often reversible with intravenous iron
chelation with desferrioxamine. Myocardial T2* improves in concert with LV
volumes and function during recovery, but iron clearance from the heart is
considerably slower than from the liver.
PMID: 15491298 [PubMed - in process]
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| Manky Badger 2004-10-26, 7:27 pm |
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"doe" <ironjustice@aol.comdoe> wrote in message
news:20041020050849.03267.00002056@mb-m17.aol.com...
> Br J Haematol. 2004 Nov;127(3):348-55. Links
Do you honestly think anyone will find this surprising, Tom ?
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