Methods are now available to measure the magnitude of iron accumulation in the heart. Their validation currently relies on indirect evidence and not on chemical estimation in cardiac biopsies. All patients with symptomatic heart disease appear to have abnormal T2* values, but many patients without symptomatic heart disease also have evidence of increased myocardial iron. Although there is no proof to date that increased myocardial iron, as evidenced by abnormal magnetic resonance imaging, carries an adverse prognosis, it is likely that such new information will affect the chelating programme of patients. In these cases, there are a number of options available: (i) ongoing treatment with either desferrioxamine (DFO) or deferiprone may be intensified; (ii) the patient may be switched to the alternative chelator or (iii) combined chelation with both DFO and deferiprone may be started, which is more effective than using either chelator alone. For patients with symptomatic heart disease, continuous intravenous DFO with, or without deferiprone, remains the currently recommended treatment, in view of its documented ability to salvage these patients.

Hershko, C., Cappellini, M., Galanello, R., Piga, A., Tognoni, G., Masera, G. (2004). Purging iron from the heart. BRITISH JOURNAL OF HAEMATOLOGY, 125(5), 545-551 [10.1111/j.1365-2141.2004.04946.x].

Purging iron from the heart

MASERA, GIUSEPPE
2004

Abstract

Methods are now available to measure the magnitude of iron accumulation in the heart. Their validation currently relies on indirect evidence and not on chemical estimation in cardiac biopsies. All patients with symptomatic heart disease appear to have abnormal T2* values, but many patients without symptomatic heart disease also have evidence of increased myocardial iron. Although there is no proof to date that increased myocardial iron, as evidenced by abnormal magnetic resonance imaging, carries an adverse prognosis, it is likely that such new information will affect the chelating programme of patients. In these cases, there are a number of options available: (i) ongoing treatment with either desferrioxamine (DFO) or deferiprone may be intensified; (ii) the patient may be switched to the alternative chelator or (iii) combined chelation with both DFO and deferiprone may be started, which is more effective than using either chelator alone. For patients with symptomatic heart disease, continuous intravenous DFO with, or without deferiprone, remains the currently recommended treatment, in view of its documented ability to salvage these patients.
Articolo in rivista - Articolo scientifico
Pyridones; Iron Chelating Agents; Deferoxamine; Cardiomyopathies; Iron Overload; Magnetic Resonance Spectroscopy; Cardiotonic Agents; Humans
English
545
551
7
Hershko, C., Cappellini, M., Galanello, R., Piga, A., Tognoni, G., Masera, G. (2004). Purging iron from the heart. BRITISH JOURNAL OF HAEMATOLOGY, 125(5), 545-551 [10.1111/j.1365-2141.2004.04946.x].
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/14109
Citazioni
  • Scopus 39
  • ???jsp.display-item.citation.isi??? 32
Social impact