N-terminal fragment of proBNP is a marker of risk for right ventricular dysfunction and cardiac complications in thalass
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N-terminal fragment of proBNP is a marker of risk for right ventricular dysfunction and cardiac complications in thalassemia major Antonella Meloni1, Alessia Pepe1, Luc Zyw1, Vincenzo Positano1, Maria Chiara Dell'Amico1, Claudio Passino1, Assunta Agazio1, Serena Tommasi1, Maria Eliana Lai2, Michele Ein1 and Massimo Lombardi*1 Address: 1G Monasterio Foundation and Institute of Clinical Physiology, CNR, Pisa, Italy and 2Ospedale microcitemico, Cagliari, Italy * Corresponding author
from 13th Annual SCMR Scientific Sessions Phoenix, AZ, USA. 21-24 January 2010 Published: 21 January 2010 Journal of Cardiovascular Magnetic Resonance 2010, 12(Suppl 1):P284
doi:10.1186/1532-429X-12-S1-P284
Abstracts of the 13th Annual SCMR Scientific Sessions - 2010
Meeting abstracts - A single PDF containing all abstracts in this Supplement is available here. http://www.biomedcentral.com/content/files/pdf/1532-429X-11-S1-infoThis abstract is available from: http://jcmr-online.com/content/12/S1/P284 © 2010 Meloni et al; licensee BioMed Central Ltd.
Introduction Cardiac complications are the main cause of morbidity and mortality in thalassemia major (TM). In particular, thalassemic cardiomyopathy include forms with right involvement difficult to detect by usual approach, whereas early diagnosis could permit early treatment and improvement in prognosis. Plasma N-terminal fragment of proBNP (NT-proBNP) concentration holds a known value in asymptomatic cardiac patients, too, but its usefulness in the management of TM has not been fully investigated.
Purpose Aim of our study was to assess both diagnostic and prognostic role of NT-proBNP in a large prospective cohort of TM patients, evaluated by cardiovascular magnetic resonance (CMR).
Methods 176 TM patients (age 30 ± 9 years, 54% females) underwent consecutively CMR (1.5 T) and blood sampling for plasma assay of NT-proBNP (ECLIA method). Myocardial iron overload was assessed using a multislice multiecho T2* approach able to provide the global T2* value in the left ventricle. Cine sequences were obtained to quantify biventricular morphological and functional parameters. RV and LV volumes and ejection fraction (EF) were evalu-
ated by a semi-automatic software (Mass Plus, Leiden, NL). Myocardial fibrosis was evaluated by late gadolinium-enhanced (Gadovist®; Bayer Schering Pharma; Berlin, Germany) acquisitions. Fibrosis extent was evaluated visually using a two-point scale: enhancement absent or present.
Results NT-proBNP was associated positively with right ventricular (RV) end systolic volume (r = 0.2, P = 0.045) and negatively with RV ejection fraction (EF) (r = -0.2, P = 0.001). The fibrosis group showed significantly higher NTproBNP values vs the no-fibrosis group (median, 25th75th percentile 171, 67-330 ng/l vs 71, 32-134; p = 0.038). No correlation was observed between NT-proBNP levels and myocardial iron overload. Patients with cardiac complications (heart failure, arrhythmias, pulmonary hypertension) showed higher NT-p
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