Prospective cardiac magnetic resonance imaging survey in myelodysplastic syndrome patients: insights from an Italian network.

Autor: Pepe A; MRI Unit, Fondazione G. Monasterio CNR-Regione Toscana, Via Moruzzi, 1, 56124, Pisa, Italy. alessia.pepe@ftgm.it., Rizzo M; Reparto di Ematologia, Azienda Sanitaria Provinciale Caltanissetta-Ospedale 'Sant'Elia', Caltanisetta, Italy., Galimberti S; Dipartimento di Medicina Clinica e Sperimentale, UO Ematologia, Università degli Studi di Pisa, Pisa, Italy., Baratè C; Dipartimento di Medicina Clinica e Sperimentale, UO Ematologia, Università degli Studi di Pisa, Pisa, Italy., Oliva EN; Hematology Unit, Grande Ospedale Metropolitano Bianchi Melacrino Morelli, Reggio Calabria, Italy., Arcioni F; Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Perugia, Sez. Ematologia ed Immunologia Clinica, Ospedale 'Santa Maria della Misericordia', Perugia, Italy., Storti S; UOC di Onco-Ematologia, Università Cattolica del Sacro Cuore, Fondazione di Ricerca e Cura 'Giovanni Paolo II', Campobasso, Italy., Renne S; Struttura Complessa di Cardioradiologia-UTIC, P.O. 'Giovanni Paolo II', Lamezia Terme, Italy., Midiri M; Sezione di Scienze Radiologiche-Dipartimento di Biopatologia e Biotecnologie Mediche, Policlinico 'Paolo Giaccone', Palermo, Italy., Restaino G; Dipartimento di Immagini, Fondazione di Ricerca e Cura 'Giovanni Paolo II', Campobasso, Italy., Positano V; MRI Unit, Fondazione G. Monasterio CNR-Regione Toscana, Via Moruzzi, 1, 56124, Pisa, Italy., Mangione M; Unità Operativa Sistemi Informatici, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy., Meloni A; MRI Unit, Fondazione G. Monasterio CNR-Regione Toscana, Via Moruzzi, 1, 56124, Pisa, Italy.
Jazyk: angličtina
Zdroj: Annals of hematology [Ann Hematol] 2021 May; Vol. 100 (5), pp. 1139-1147. Date of Electronic Publication: 2021 Mar 19.
DOI: 10.1007/s00277-021-04495-y
Abstrakt: We prospectively evaluated changes in cardiac and hepatic iron overload (IO) and in morpho-functional cardiac parameters and myocardial fibrosis by magnetic resonance imaging (MRI) in patients with low-risk and intermediate-1-risk myelodysplastic syndromes (MDS). Fifty patients enrolled in the Myocardial Iron Overload in MyElodysplastic Diseases (MIOMED) study were followed for 12 months. IO was quantified by the T2* technique and biventricular function parameters by cine images. Macroscopic myocardial fibrosis was detected by late gadolinium enhancement technique. Twenty-eight patients (71.89±8.46 years; 8 females) performed baseline and follow-up MRIs. Thirteen patients had baseline hepatic IO, with a higher frequency among transfusion-dependent patients. Out of the 15 patients with a baseline MRI liver iron concentration <3 mg/g/dw, two (non-chelated) developed hepatic IO. Thirteen (46.4%) patients had an abnormal T2* value in at least one myocardial segment. One patient without hepatic IO and non-transfused had baseline global T2* <20 ms. Among the 15 patients with no baseline myocardial IO (MIO), 2 worsened. There was a significant increase in both left and right ventricular end-diastolic volume indexes. Thirty-six percent of patients showed myocardial fibrosis correlating with aging. Two new occurrences were detected at the follow-up. In conclusion, by a more sensitive segmental approach, MIO is quite frequent in MDS patients and it can be present also in non-transfused patients and in absence of detectable hepatic iron. The incidence of cardiac and hepatic IO and of myocardial fibrosis and the increase in biventricular volumes after a 12-month interval suggest performing periodic MRI scans to better manage MDS patients.
Databáze: MEDLINE
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