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Effect of splenectomy on cardiac iron and function in different transfusion-dependent patients

Session Poster session 5

Speaker Antonella Meloni

Event : ESC Congress 2014

  • Topic : imaging
  • Sub-topic : Cardiac Magnetic Resonance (CMR)
  • Session type : Poster Session

Authors : A Meloni (Pisa,IT), P Keilberg (Pisa,IT), P Preziosi (Roma,IT), G Roccamo (S. Agata di Militello (ME),IT), S Macchi (Ravenna,IT), V Positano (Pisa,IT), C Tudisca (Palermo,IT), G Serra (Copertino (LE),IT), S Renne (Lamezia Terme,IT), A Pepe (Pisa,IT)

Authors:
A. Meloni1 , P. Keilberg1 , P. Preziosi2 , G. Roccamo3 , S. Macchi4 , V. Positano1 , C. Tudisca5 , G. Serra6 , S. Renne7 , A. Pepe1 , 1Fondazione G. Monasterio CNR-Regione Toscana, CMR Unit - Pisa - Italy , 2Policlinico “Casilino”, U.O.C. Diagnostica per Immagini e Interventistica - Roma - Italy , 3PO di S.Agata di Militello (ASP-ME), Unità di Prevenzione e Cura delle Mictrocitemie - S. Agata di Militello (ME) - Italy , 4Ospedale Santa Maria delle Croci, Servizio Trasfusionale - Ravenna - Italy , 5Policlinico “Paolo Giaccone”, Istituto di Radiologia - Palermo - Italy , 6Presidio Osp. no. 2 “S. Giuseppe da Copertino” - Copertino (LE) - Italy , 7P.O. “Giovanni Paolo II”, Struttura Complessa di Radiologia - Lamezia Terme - Italy ,

Topic(s):
Cardiovascular Magnetic Resonance (CMR)

Citation:
European Heart Journal ( 2014 ) 35 ( Abstract Supplement ), 796-797

Purpose: The main therapeutic rationale for splenectomy in transfusion-dependent patients with hemoglobinopathies is to decrease blood consumption and transfusion requirement. However, since the spleen is a large physiologic iron depot, splenectomy may have a possible role of in determining extrahepatic iron overload.

This study aims to observe retrospectively the effect of splenectomy on cardiac iron and function in different groups of transfusion-dependent patients.

Methods: 1735 transfusion-dependent patients enrolled in the Myocardial Iron Overload in Thalassemia (MIOT) Network were considered. 14 patients had sickle-thalassemia, 23 patients had sickle-cell disease (SCD), 179 had thalassemia intermedia (TI) and 1519 had thalassemia major (TM). Cardiac iron was assessed using a multislice multiecho T2* approach. Left ventricular ejection fraction (LV EF) was quantified by cine sequences.

Results: The frequency of splenectomy was: 21.4% in sickle-thalassemia, 65.2% in SCD, 84.9% in TI and 55.1% in TM (P<0.0001).

Splenectomized TM patients were older than non-splenectomized patients (34.3±7.9 yrs vs 27.2±7.8 yrs; P<0.0001). In each hemoglobinopathy, cardiac T2* and LV EF were comparable between splenectomised and non-splenectomized patients (Fig. 1).

Conclusions: Regardless by the type of hemoglobinopathy, in regularly transfused patients splenectomy was not associated with increased cardiac iron and reduced cardiac function.

Figure 1

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