Evidence map›Paper›PMID 34849707›Full record

ArticleEuropean heart journal. Quality of care & clinical outcomes2022

Use of rapid cardiac magnetic resonance imaging to guide chelation therapy in patients with transfusion-dependent thalassaemia in India: UMIMI study.

Katia Menacho Medina, Amna Abdel-Gadir, Kartik Ganga, Vineeta Ojha, Surya Pratap, Redha Boubertakh, Louise McGrath, João B Augusto, Alexander Rikowski, Nabila Mughal and 13 more

Open access · hybridAbstract read
In one paragraph

Article in European heart journal. Quality of care & clinical outcomes, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.1field-weighted citation impact, top 48% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Iron overload cardiomyopathy.Heart failure reviews · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors at 8 institutions in 2 countries.

Katia Menacho MedinaInstitute of Cardiovascular Science, University College London, London, UK.ORCID 0000-0001-5183-5655
Amna Abdel-GadirInstitute of Cardiovascular Science, University College London, London, UK.
Kartik GangaDepartment of Radiology, AlI India Institute of Medical Sciences, New Delhi, India.
Vineeta OjhaDepartment of Radiology, AlI India Institute of Medical Sciences, New Delhi, India.
Surya PratapDepartment of Radiology, AlI India Institute of Medical Sciences, New Delhi, India.
Redha BoubertakhBarts Heart Centre, Saint Bartholomew's Hospital, London, UK.
Louise McGrathChenies Mews Cardiac Imaging Centre, London, UK.
João B AugustoInstitute of Cardiovascular Science, University College London, London, UK.
Alexander RikowskiKCL Library Services, King's College London University and Hospital, London, UK.
Nabila MughalKCL Library Services, King's College London University and Hospital, London, UK.
Virender Kumar KhannaClinical Paediatrics, Sir Ganga Ram Hospital, Sir Ganga Ram Hospital Marg, Rajinder Nagar, New Delhi, India.
Tulika SethDepartment of Radiology, AlI India Institute of Medical Sciences, New Delhi, India.
Sanjiv SharmaDepartment of Radiology, AlI India Institute of Medical Sciences, New Delhi, India.
Amita MahajanHaematology Department, Indraprastha Apollo Hospitals, New Delhi, India.
Rajiv K BansalDepartment of Haematology, Santokba Durlabhji Memorial Hospital Cum Medical Research Institute, Jaipur, India.
Prabhar SrivastavaDepartment of Haematology, Santokba Durlabhji Memorial Hospital Cum Medical Research Institute, Jaipur, India.
Harsh MahajanMahajan Imaging Centre PVT, New Delhi, India.
Vidhur MahajanMahajan Imaging Centre PVT, New Delhi, India.
Judith WalkerThe Hatter Cardiovascular Institute, University College London Hospital, 67 Chenies Mews, Bloomsbury, London WCIE 6HX, UK.
Tenzin SeldonThe Hatter Cardiovascular Institute, University College London Hospital, 67 Chenies Mews, Bloomsbury, London WCIE 6HX, UK.
Emmanuel AkoDepartment of Cardiology, Chelsea & Westminster Hospital, London, UK.
James C MoonInstitute of Cardiovascular Science, University College London, London, UK.
John Malcolm WalkerInstitute of Cardiovascular Science, University College London, London, UK.ORCID 0000-0002-8559-7218
St Bartholomew's Hospital · GBAll India Institute of Medical Sciences · INUniversity College London Hospitals NHS Foundation Trust · GBKing's College London · GBSawai Man Singh Hospital · INIndraprastha Apollo Hospitals · INRoyal London Hospital · GBSir Ganga Ram Hospital · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsTo explore the impact of incorporating a faster cardiac magnetic resonance (CMR) imaging protocol in a low-middle-income country (LMIC) and using the result to guide chelation in transfusion-dependent patients. METHODS AND

resultsA prospective UK-India collaborative cohort study was conducted in two cities in India. Two visits 13 months apart included clinical assessment and chelation therapy recommendations based on rapid CMR results. Participants were recruited by the local patient advocate charity, who organized the patient medical camps. The average scanning time was 11.3 ± 2.5 min at the baseline and 9.8 ± 2.4 min (P < 0.001) at follow-up. The baseline visit was attended by 103 patients (mean age 25 years) and 83% attended the second assessment. At baseline, 29% had a cardiac T2* < 20 ms, which represents significant iron loading, and 12% had left ventricular ejection fraction <60%, the accepted lower limit in this population. Only 3% were free of liver iron (T2* ≥ 17 ms). At 13 months, more patients were taking intensified dual chelation therapy (43% vs. 55%, P = 0.002). In those with cardiac siderosis (baseline T2* < 20 ms), there was an improvement in T2*-10.9 ± 5.9 to 13.5 ± 8.7 ms, P = 0.005-and fewer were classified as having clinically important cardiac iron loading (T2* < 20 ms, 24% vs. 16%, P < 0.001). This is the first illustration in an LMIC that incorporating CMR results into patient management plans can improve cardiac iron loading.

conclusionFor thalassaemia patients in an LMIC, a simplified CMR protocol linked to therapeutic recommendation via the patient camp model led to enhanced chelation therapy and a reduction in cardiac iron in 1 year.

Indexed as

beta-ThalassemiaThalassemiaAdultChelation TherapyCohort StudiesHumansIronMagnetic Resonance ImagingProspective StudiesStroke VolumeVentricular Function, LeftIronCardiac magnetic resonanceIndiaLow–middle-income countryMyocardial iron overloadThalassaemia

Identifiers

PMID34849707
PMCPMC9071579
OpenAlexW3214981977

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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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.