Pancreatic T2* Magnetic Resonance Imaging for Prediction of Cardiac Arrhythmias in Transfusion-Dependent Thalassemia
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Magnetic Resonance Imaging
2.3. Diagnostic Criteria and Clinical Follow-Up
2.4. Statistical Analysis
3. Results
3.1. Baseline Findings
3.2. Cardiac Complications
3.3. Characterization of Patients Who Developed Cardiac Arrhythmias
3.4. Prognostic Markers of Arrhythmias
3.5. Global Pancreas T2* and Prediction of Arrhythmias
3.6. Best Cut-Off of Global Pancreas T2* for Risk Prediction
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variable | All Patients (N = 813) | Patients without Arrhythmias (N = 793) | Patients with Arrhythmias (N = 20) | p-Value |
---|---|---|---|---|
Females, N (%) | 444 (54.6) | 438 (55.2) | 6 (30.0) | 0.025 |
Age (yrs) | 36.47 ± 10.71 | 36.27 ± 10.72 | 44.47 ± 6.81 | <0.0001 |
Splenectomy, N (%) | 449 (55.2) | 435 (54.9) | 14 (70) | 0.179 |
Pretransfusion hemoglobin (g/dL) | 9.67 ± 0.55 | 9.67 ± 0.55 | 9.68 ± 0.54 | 0.965 |
Serum ferritin (ng/L) | 1061.24 ± 1330.85 | 1066.71 ± 1336.84 | 860.62 ± 1099.31 | 0.059 |
Diabetes, N (%) | 89/796 (11.2) | 83/776 (10.7) | 6/20 (30.0) | 0.007 |
MRI LIC (mg/g/dw) | 5.88 ± 8.72 | 5.79 ± 8.52 | 9.02 ± 14.50 | 0.556 |
Global pancreas T2* (ms) | 13.16 ± 10.49 | 13.32 ± 10.54 | 6.79 ± 5.11 | 0.001 |
Global heart T2* (ms) | 37.32 ± 9.40 | 37.33 ± 9.38 | 36.77 ± 10.45 | 0.977 |
N. of segments with T2* < 20 ms | 1.49 ± 4.06 | 1.49 ± 4.06 | 1.40 ± 3.89 | 0.792 |
LV EDVI (mL/m2) | 82.15 ± 16.84 | 82.14 ± 16.67 | 82.59 ± 24.00 | 0.845 |
LV EF (%) | 62.41 ± 6.59 | 62.38 ± 6.61 | 63.88 ± 5.43 | 0.335 |
LV mass index (g/m2) | 54.81 ± 13.43 | 54.76 ± 13.44 | 57.18 ± 12.68 | 0.410 |
RV EDVI (mL/m2) | 80.34 ± 17.63 | 80.34 ± 17.48 | 80.06 ± 23.97 | 0.436 |
RV EF (%) | 60.86 ± 7.09 | 60.79 ± 7.09 | 62.59 ± 6.34 | 0.076 |
Replacement myocardial fibrosis, N (%) | 56/224 (25.0) | 54/218 (24.8) | 2/6 (33.3) | 0.633 |
Left atrial area (cm2/m2) | 12.89 ± 2.50 | 12.82 ± 2.43 | 15.36 ± 3.69 | 0.002 |
Right atrial area (cm2/m2) | 11.85 ± 2.38 | 11.79 ± 2.29 | 13.75 ± 3.95 | 0.014 |
Independent Variable | Univariate Analysis | |
---|---|---|
HR (95% CI) | p-Value | |
Male gender | 2.71 (1.04–7.06) | 0.041 |
Age | 1.11 (1.05–1.17) | <0.0001 |
Splenectomy | 1.75 (0.67–4.54) | 0.254 |
Pretransfusion hemoglobin | 1.12 (0.49–2.56) | 0.780 |
Serum ferritin | 1.00 (0.99–1.00) | 0.549 |
Diabetes | 3.15 (1.21–8.19) | 0.019 |
MRI LIC | 1.02 (0.99–1.05) | 0.113 |
Global pancreas T2* | 0.89 (0.81–0.98) | 0.015 |
Global heart T2* | 0.99 (0.95–1.04) | 0.893 |
N. of segments with T2* < 20 ms | 0.99 (0.88–1.11) | 0.831 |
LV EDVI | 1.00 (0.97–1.03) | 0.915 |
LV EF | 1.03 (0.96–1.11) | 0.409 |
LV mass index | 1.01 (0.98–1.05) | 0.580 |
RV EDVI | 0.99 (0.97–1.03) | 0.870 |
RV EF | 1.06 (0.99–1.13) | 0.122 |
Replacement myocardial fibrosis | 1.46 (0.27–7.99) | 0.662 |
Left atrial area index | 1.31 (1.16–1.49) | <0.0001 |
Right atrial area index | 1.29 (1.12–1.45) | <0.0001 |
Multivariate Analysis with Global Pancreas T2* as Fixed Independent Variable | |||
---|---|---|---|
Predictor | HR (95% CI) | p-Value | |
Model 1: crude | pancreas T2* | 0.89 (0.81–0.98) | 0.015 |
Model 2: inclusion of age and gender | pancreas T2* | 0.88 (0.78–0.99) | 0.026 |
age | 1.11 (1.05–1.19) | 0.001 | |
male gender | 3.48 (1.32–9.15) | 0.012 | |
Model 3: inclusion of diabetes | pancreas T2* | 0.89 (0.82–0.98) | 0.023 |
diabetes | 2.37 (0.91–6.21) | 0.078 | |
Model 3: inclusion of left atrial area index | pancreas T2* | 0.89 (0.79–0.98) | 0.024 |
left atrial area index | 1.39 (1.20–1.62) | <0.0001 | |
Model 4: inclusion of previous arrhythmias | pancreas T2* | 0.89 (0.82–0.98) | 0.021 |
previous arrhythmias | 11.32 (3.27–39.19) | <0.0001 |
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Meloni, A.; Pistoia, L.; Ricchi, P.; Positano, V.; Longo, F.; Borsellino, Z.; Cecinati, V.; Messina, G.; Corigliano, E.; Rosso, R.; et al. Pancreatic T2* Magnetic Resonance Imaging for Prediction of Cardiac Arrhythmias in Transfusion-Dependent Thalassemia. J. Clin. Med. 2023, 12, 6015. https://doi.org/10.3390/jcm12186015
Meloni A, Pistoia L, Ricchi P, Positano V, Longo F, Borsellino Z, Cecinati V, Messina G, Corigliano E, Rosso R, et al. Pancreatic T2* Magnetic Resonance Imaging for Prediction of Cardiac Arrhythmias in Transfusion-Dependent Thalassemia. Journal of Clinical Medicine. 2023; 12(18):6015. https://doi.org/10.3390/jcm12186015
Chicago/Turabian StyleMeloni, Antonella, Laura Pistoia, Paolo Ricchi, Vincenzo Positano, Filomena Longo, Zelia Borsellino, Valerio Cecinati, Giuseppe Messina, Elisabetta Corigliano, Rosamaria Rosso, and et al. 2023. "Pancreatic T2* Magnetic Resonance Imaging for Prediction of Cardiac Arrhythmias in Transfusion-Dependent Thalassemia" Journal of Clinical Medicine 12, no. 18: 6015. https://doi.org/10.3390/jcm12186015