Correlation study between magnetic resonance imaging-quantitated cardiac iron deposition and left ventricular function in patients with β-thalassemia major in China.

Objective: To explore the correlation between cardiac iron deposition and left ventricular function indicators, such as left ventricular end-diastolic volume index, left ventricular end-systolic volume index, and left ventricular ejection fraction, and to evaluate the accuracy of predicting patients with cardiac iron deposition by using left ventricular ejection fraction as an index.

Methods: This quantitative cross-sectional study involved one hundred and fifty transfusion-dependent patients with β-thalassemia major who were evaluated by magnetic resonance imaging to obtain T₂* values, left ventricular end-diastolic volume index, left ventricular end-systolic volume index, and left ventricular ejection fraction. The relationship between cardiac R₂* values and left ventricular end-diastolic volume index, left ventricular end-systolic volume index, and left ventricular ejection fraction was analyzed.

Results: Out of the 150 patients, cardiac iron overload was not observed for 92 patients, 42 patients exhibited mild to moderate cardiac iron overload, and 16 patients were severe cardiac iron overloaded. A linear correlation was not observed between the cardiac R₂* values and left ventricular end-diastolic volume index, left ventricular end-systolic volume index, and left ventricular ejection fraction (P > 0.05). For the left ventricular ejection fraction index, the sensibility, specificity, positive predictive value, negative predictive value, and the agreement rate were 83.3%, 63.2%, 8.6%, 98.9%, and 64.0%, respectively; also, the area under the receiver operating characteristic curve was 0.348.

Conclusions: A linear correlation was not observed between cardiac R₂* values and left ventricular end-diastolic volume index, left ventricular end-systolic volume index, and left ventricular ejection fraction in patients with β-thalassemia major. Therefore, using left ventricular ejection fraction as an indirect index to predict cardiac iron deposition may be not reliable in clinical practice.