Aquaro Giovanni D

Chiodi Elisabetta

Dell'Amico Maria

Favilli Brunella

Festa Pierluigi

Galati Maria

Keilberg Petra

Lombardi Massimo

Meloni Antonella

Pepe Alessia

Positano Vincenzo

Renne Stefania

Sardella Leonardo

Antonella Meloni

Maria Dell'Amico

Brunella Favilli

Giovanni D Aquaro

Pierluigi Festa

Elisabetta Chiodi

Stefania Renne

Maria Galati

Leonardo Sardella

Petra Keilberg

Vincenzo Positano

Massimo Lombardi

Alessia Pepe

Springer - Publisher Connector

Left Ventricular Volumes, Mass and Function normalized to the body surface area, age and gender from CMR in a large cohort of well-treated Thalassemia Major patients without myocardial iron overload

Meloni A

Dell’Amico MC

Favilli B

Aquaro GD

Festa P

Chiodi E

Renne S

Restaino G

Positano V

Galati MC

Lombardi M

Pepe A

Archivio istituzionale della ricerca - Università di Padova

Left Ventricular Volumes, Mass and Function normalized to the body surface area, age and gender from CMR in a large cohort of well-treated Thalassemia Major patients without myocardial iron overload.

Aquaro G

Tudisca C

Keilberg P

Left ventricular volumes, mass and function normalized to the body surface area, age and gender from CMR in a large cohort of well-treated thalassemia major patients without myocardial iron overload

Maria Chiara Dell'Amico

Maria Concetta Galati

Crossref

Journal of Cardiovascular Magnetic Resonance

POSTER PRESENTATION Open Access
Left Ventricular Volumes, Mass and Function
normalized to the body surface area, age and
gender from CMR in a large cohort of well-
treated Thalassemia Major patients without
myocardial iron overload
Antonella Meloni1*, Maria Chiara Dell’Amico1, Brunella Favilli1, Giovanni D Aquaro1, Pierluigi Festa1,
Elisabetta Chiodi2, Stefania Renne3, Maria Concetta Galati4, Leonardo Sardella5, Petra Keilberg1, Vincenzo Positano1,
Massimo Lombardi1, Alessia Pepe1
From 2011 SCMR/Euro CMR Joint Scientific Sessions
Nice, France. 3-6 February 2011
Introduction
Cardiovascular Magnetic Resonance (CMR) allows an
accurate and reproducible quantification of left ventricu-
lar (LV) parameters. In Thalassemia major (TM)
patients have been reported different “normal” LV
values due to chronic anemia and eventually pre-existing
iron burdens. Moreover, in this population it is
unknown the influence of sex and age on LV parameters
and no ranges of normal have been reported using
MASS® software. The aim of this study was to establish
the ranges for normal LV volumes, mass and ejection
fraction normalized to the influence of body surface
area(BSA), age and sex from CMR in a large cohort of
well-treated TM patients without myocardial iron
overload.
Materials
Among the 923 TM patients who underwent CMR
within the MIOT network for the assessment of cardiac
iron overload, function and fibrosis, we selected 142
patients with no known risk factors or history of cardiac
disease, normal electrocardiogram, no myocardial fibro-
sis and no myocardial iron overload (all the cardiac seg-
ments with a normal T2* value). All patients had been
regularly transfused and chelated since early childhood.
Moreover, we studied 71 healthy subjects matched for
age and sex. LV function parameters were quantitatively
evaluated in a standard way by SSFP cine images using
MASS® software. LV end-diastolic volume, end-systolic
volume, stroke volume, and mass were normalized to
BSA (EDVI, ESVI, SVI, massI).
Results
Table 1 shows the comparison of the CMR parameters
with differentiation for sex and age in TM patients and
healthy subjects and the cut-off of normality defined as
mean - 2 standard deviation (SD). TM patients showed
significantly lower BSA than the controls (P<0.0001).
Significantly higher EDVI and SVI were found only for
males 30 years. Significantly higher LVEF were found
only for males < 14 years. In TM patients all LV
volumes indexes were significantly larger in males than
in females (P<0.0001 in all cases). The EF was not dif-
ferent between the sexes. In males the ESVI and the EF
were significant different among the age groups
(P=0.006 and P=0.001, respectively). In females no sig-
nificant differences were detected among the age
groups.
Conclusion
In a large cohort of well-treated TM patients significant
differences in LV parameters compared to controls were1“G. Monasterio” Foundation and Institute of Clinical Physiology, CNR, Pisa, Italy
Full list of author information is available at the end of the article
Meloni et al. Journal of Cardiovascular Magnetic Resonance 2011, 13(Suppl 1):P305
http://jcmr-online.com/content/13/S1/P305
© 2011 Meloni et al; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons
Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly cited.
limited to males < 14 years and > 30 years. Appropriate
“normal” reference ranges normalized to BSA, sex and
age should be used to avoid misdiagnosis of cardiomio-
pathy in TM patients.
Author details
1“G. Monasterio” Foundation and Institute of Clinical Physiology, CNR, Pisa, Italy.
2Arcispedale “S. Anna”, Ferrara, Italy. 3P.O. “Giovanni Paolo II”, Lamezia Terme,
Italy. 4A.O. “Pugliese-Ciaccio”, Catanzaro, Italy. 5A.S.L. BA - Osp. “Di Venere”, Bari,
Italy.
Published: 2 February 2011
doi:10.1186/1532-429X-13-S1-P305
Cite this article as: Meloni et al.: Left Ventricular Volumes, Mass and
Function normalized to the body surface area, age and gender from
CMR in a large cohort of well-treated Thalassemia Major patients
without myocardial iron overload. Journal of Cardiovascular Magnetic
Resonance 2011 13(Suppl 1):P305.
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Table 1
< 14 14-20 20-30 30-40 >=40
TM H P TM H P TM H P TM H P TM H P
Males N=7 N=7 N=6 N=6 N=25 N1=15 N=23 N=11 N=6 N=5
EDVI (ml/m2) 94 ± 18
(58)
75 ± 11 0.034 96 ± 20
(56)
91 ± 20 0.715 103 ± 17
(69)
101 ±
13
0.686 92 ± 15
(62)
80 ± 11 0.222 94 ± 9
(76)
75 ± 11 0.013
ESVI (ml/m2) 31 ± 6
(19)
24 ± 6 0.058 36 ± 8
(22)
35 ± 14 0.760 38 ± 8
(22)
39 ± 9 0.676 32 ± 6
(20)
29 ± 6 0.160 29 ± 6
(17)
28 ± 10 0.816
SVI (ml/m2) 63 ± 14
(35)
51 ± 7 0.05 57 ± 12
(33)
56 ± 8 0.868 65 ± 10
(45)
62 ± 9 0.433 59 ± 10
(39)
51 ± 10 0.027 64 ± 8
(48)
47 ± 8 0.007
Mass I (g/m2) 57 ± 7
(43)
68 ± 5 0.007 57 ± 13
(31)
71 ± 7 0.043 66 ± 12
(42)
77 ± 12 0.006 62 ± 12
(38)
66 ± 10 0.184 69 ± 16
(36)
74 ± 11 0.536
EF (%) 66 ± 4
(58)
54 ± 6 <0.0001 60 ± 2
(56)
66 ± 14 0.322 63 ± 3
(57)
62 ± 6 0.520 65 ± 3
(59)
65 ± 8 0.972 68 ± 6
(56)
62 ± 9 0.234
Females N=2 N=2 N=8 N=6 N=24 N=6 N=33 N=8 N=8 N=5
EDVI (ml/m2) 53 ± 8
(47)
62 ± 4 0.951 81 ± 8
(65)
80 ± 9 0.866 83 ± 16
(51)
78 ± 9 0.499 77 ± 11
(55)
79 ± 10 0.669 82 ± 19
(44)
77 ± 16 0.614
ESVI (ml/m2) 23 ± 1
(21)
22 ±8 0.823 30 ± 6
(18)
31 ± 3 0.789 30 ± 8
(14)
30 ± 4 0.883 26 ± 6
(14)
29 ± 7 0.216 26 ± 8
(12)
28 ± 12 0.974
SVI (ml/m2) 40 ± 7
(26)
41 ± 4 0.919 49 ± 3
(43)
49 ± 6 0.892 53 ± 9
(35)
48 ± 6 0.234 51 ± 6
(39)
50 ± 8 0.915 54 ±11
(32)
49 ± 6 0.394
Mass I (g/m2) 34 ± 3
(28)
59 ± 19 0.296 47 ± 8
(31)
56 ± 6 0.040 53 ± 9
(35)
54 ± 12 0.893 52 ± 9
(34)
55 ± 13 0.465 51 ± 12
(27)
56 ± 5 0.344
EF (%) 62 ± 3
(57)
46 ± 17 0.388 63 ± 4
(55)
62 ± 4 0.694 65 ± 5
(55)
62 ± 3 0.137 66 ± 5
(56)
63 ± 7 0.271 66 ± 4
(58)
63 ± 7 0.254
Meloni et al. Journal of Cardiovascular Magnetic Resonance 2011, 13(Suppl 1):P305
http://jcmr-online.com/content/13/S1/P305
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Left Ventricular Volumes, Mass and Function normalized to the body surface area, age and gender from CMR in a large cohort of well-treated Thalassemia Major patients without myocardial iron overload

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