ArticleJournal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance2011
On improvement in ejection fraction with iron chelation in thalassemia major and the risk of future heart failure.
Article in Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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Who cites it
26 citing papers in PubMed, 63 citations in OpenAlex.
- Deferiprone vs deferoxamine for transfusional iron overload in SCD and other anemias: a randomized, open-label noninferiority study.Blood advances · 2022Trial
- Targeting chelatable iron as a therapeutic modality in Parkinson's disease.Antioxidants & redox signaling · 2014Trial
- Trial
- Deferasirox for up to 3 years leads to continued improvement of myocardial T2* in patients with β-thalassemia major.Haematologica · 2012Trial
- Intranasal delivery of iron chelators and management of central nervous system disease.Frontiers in pharmacology · 2025Review
- The role of mitochondria in iron overload-induced damage.Journal of translational medicine · 2024Review
- Use of rapid cardiac magnetic resonance imaging to guide chelation therapy in patients with transfusion-dependent thalassaemia in India: UMIMI study.European heart journal. Quality of care & clinical outcomes · 2022Article
- Iron Chelators in Treatment of Iron Overload.Journal of toxicology · 2022Review
- The Role of MRI in Prognostic Stratification of Cardiomyopathies.Current cardiology reports · 2020Review
- Management of cardiac hemochromatosis.Archives of medical science : AMS · 2018Article
- Cardiac complications in beta-thalassemia: From mice to men.Experimental biology and medicine (Maywood, N.J.) · 2017Review
- Cost-Utility Analysis of Three Iron Chelators Used in Monotherapy for the Treatment of Chronic Iron Overload in β-Thalassaemia Major Patients: An Italian Perspective.Clinical drug investigation · 2017Article
- Getting to the "Heart" of Cardiac Disease by Decreasing Mitochondrial Iron.Circulation research · 2016Review
- Impact of cardiac magnetic resonance imaging in non-ischemic cardiomyopathies.World journal of cardiology · 2016Review
- Efficacy and safety of iron-chelation therapy with deferoxamine, deferiprone, and deferasirox for the treatment of iron-loaded patients with nontransfusion-dependent thalassemia syndromes.Drug design, development and therapy · 2016Article
- T1 at 1.5T and 3T compared with conventional T2* at 1.5T for cardiac siderosis.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2015Article
- Article
- Iron chelation therapy in transfusion-dependent thalassemia patients: current strategies and future directions.Journal of blood medicine · 2015Review
- The effect of metoprolol succinate on the cardiac function of patients with thalassaemia cardiomyopathy: a double-blind randomised study.Heart Asia · 2014Article
- Regional siderosis: a new challenge for iron chelation therapy.Frontiers in pharmacology · 2013Review
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundTrials of iron chelator regimens have increased the treatment options for cardiac siderosis in beta-thalassemia major (TM) patients. Treatment effects with improved left ventricular (LV) ejection fraction (EF) have been observed in patients without overt heart failure, but it is unclear whether these changes are clinically meaningful.
methodsThis retrospective study of a UK database of TM patients modelled the change in EF between serial scans measured by cardiovascular magnetic resonance (CMR) to the relative risk (RR) of future development of heart failure over 1 year. Patients were divided into 2 strata by baseline LVEF of 56-62% (below normal for TM) and 63-70% (lower half of the normal range for TM).
resultsA total of 315 patients with 754 CMR scans were analyzed. A 1% absolute increase in EF from baseline was associated with a statistically significant reduction in the risk of future development of heart failure for both the lower EF stratum (EF 56-62%, RR 0.818, p < 0.001) and the higher EF stratum (EF 63-70%, RR 0.893 p = 0.001).
conclusionThese data show that during treatment with iron chelators for cardiac siderosis, small increases in LVEF in TM patients are associated with a significantly reduced risk of the development of heart failure. Thus the iron chelator induced improvements in LVEF of 2.6% to 3.1% that have been observed in randomized controlled trials, are associated with risk reductions of 25.5% to 46.4% for the development of heart failure over 12 months, which is clinically meaningful. In cardiac iron overload, heart mitochondrial dysfunction and its relief by iron chelation may underlie the changes in LV function.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.