ArticleJournal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance2017
Post-mortem study of the association between cardiac iron and fibrosis in transfusion dependent anaemia.
Article in Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00520559 (Incidence of Cardiac Complications in Patients With Cardiac Siderosis During 1 Year Follow-up and the Normal T2* Ranges in LVF, MI and Normal Population.), which is not on this map. Cited by 11 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Incidence of Cardiac Complications in Patients With Cardiac Siderosis During 1 Year Follow-up and the Normal T2* Ranges in LVF, MI and Normal Population.
Who cites it
11 citing papers in PubMed, 19 citations in OpenAlex.
- Cardiac injury caused by iron overload in thalassemia.Frontiers in pediatrics · 2025Review
- Beta-Thalassemia Major and Myocardial Iron Overload: A Longitudinal Study with Magnetic Resonance Imaging.Cardiology research and practice · 2024Article
- T2* assessment of the three coronary artery territories of the left ventricular wall by different monoexponential truncation methods.Magma (New York, N.Y.) · 2022Article
- Abnormal diastolic function and Global longitudinal strain in patients with Thalassemia Major on long term chelation therapy.The international journal of cardiovascular imaging · 2021Article
- Differential proteomic analysis of children infected with respiratory syncytial virus.Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologica · 2021Article
- Pediatric Restrictive Cardiomyopathies.Frontiers in pediatrics · 2021Review
- Management of Iron Overload in Beta-Thalassemia Patients: Clinical Practice Update Based on Case Series.International journal of molecular sciences · 2020Review
- Cardiac TJournal of magnetic resonance imaging : JMRI · 2020Review
- Journal of Cardiovascular Magnetic Resonance: 2017/2018 in review.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2019Review
- Journal of Cardiovascular Magnetic Resonance 2017.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2018Review
- A suspected bronchial carcinoma.Breathe (Sheffield, England) · 2017Article
Corrections and comments
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Authors and funding
14 authors at 9 institutions in 5 countries.
Funding
Abstract
backgroundHeart failure related to cardiac siderosis remains a major cause of death in transfusion dependent anaemias. Replacement fibrosis has been reported as causative of heart failure in siderotic cardiomyopathy in historical reports, but these findings do not accord with the reversible nature of siderotic heart failure achievable with intensive iron chelation.
methodsTen whole human hearts (9 beta-thalassemia major, 1 sideroblastic anaemia) were examined for iron loading and fibrosis (replacement and interstitial). Five had died from heart failure, 4 had cardiac transplantation for heart failure, and 1 had no heart failure (death from a stroke). Heart samples iron content was measured using atomic emission spectroscopy. Interstitial fibrosis was quantified by computer using picrosirius red (PSR) staining and expressed as collagen volume fraction (CVF) with normal value for left ventricle <3%.
resultsThe 9 hearts affected by heart failure had severe iron loading with very low T2* of 5.0 ± 2.0 ms (iron concentration 8.5 ± 7.0 mg/g dw) and diffuse granular myocardial iron deposition. In none of the 10 hearts was significant macroscopic replacement fibrosis present. In only 2 hearts was interstitial fibrosis present, but with low CVF: in one patient with no cardiac siderosis (death by stroke, CVF 5.9%) and in a heart failure patient (CVF 2%). In the remaining 8 patients, no interstitial fibrosis was seen despite all having severe cardiac siderosis and heart failure (CVF 1.86% ±0.87%).
conclusionReplacement cardiac fibrosis was not seen in the 9 post-mortem hearts from patients with severe cardiac siderosis and heart failure leading to death or transplantation, which contrasts markedly to historical reports. Minor interstitial fibrosis was also unusual and very limited in extent. These findings accord with the potential for reversibility of heart failure seen in iron overload cardiomyopathy.
trial registrationClinicalTrials.gov Identifier: NCT00520559.
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