文摘
Deferasirox (DFX) is an oral iron chelator with established efficacy and safety. We evaluated by T2* cardiovascular magnetic resonance (CMR) the efficacy of DFX in preventing and removing cardiac and liver iron load and cardiac volume changes, along 5?years in adult thalassemia major (TM) patients. Twenty-three TM patients (9 males/14 women, mean age 36?±-?years) were included in this study. Repeated CMR was performed to assess myocardial and liver iron load?(baseline t0, after 2.5 years t1, after 5 years t2). Myocardial T2* values changed progressively and increased significantly between t0 and t2 (t0: 27.15?±-.58 vs t2: 36.64?±-.68, p--.0001). At baseline evaluation, a cardiac T2* value <20?ms was detected in six patients (26?%): they showed an improvement of cardiac T2* values between t0 and t1, with normal T2* levels reached in all patients at t2. In the overall population, a significant reduction of both end-diastolic and end-systolic left ventricular volumes (EDV, ESV) were detected between t0 and t2 (EDV, t0: 132?±-1?ml vs t2: 124?±-2?ml, p--.033; ESV, t0: 48?±-4?ml vs t2: 41?±-0?ml, p--.0007). A significant reduction in liver iron concentration (LIC) was detected at t1 (5.36?±-.58?mg/g dw at baseline vs 3.35?±-.68?mg/g dw at t1, p--.004). In patients with cardiac iron overload at baseline (n.6), mean cardiac T2* values doubled at t2, and mean LIC value is reduced of 29?%. After 5?years of treatment, DFX continually and significantly reduced myocardial and liver iron overload, and it prevented further iron deposition.