PS1572 HEART DISEASE AND PANCREATIC IRON IN THALASSEMIA MAJOR

Abstract

Background:Some preliminary data have postulated a correlation between pancreatic iron overload and heart iron and function in thalassemia major (TM) patients.Aims:In the present multicenter study we explored systematically the link between pancreatic iron and heart disease in a large cohort of TM patients.Methods:We considered 880 TM patients (467 M, mean age 37.83 ± 10.05 years) enrolled in the E‐MIOT (Extension‐Myocardial Iron Overload in Thalassemia) project. T2∗ measurements were performed over pancreatic head, body and tail and global value was the mean. Myocardial iron overload (MIO) was quantified using a T2∗ segmental approach. Biventricular function parameters were assessed by cine images. Late gadolinium enhancement (LGE) images were acquired to detect myocardial fibrosis.Results:A significant correlation between pancreatic and cardiac iron was reconfirmed in this more numerous population and a normal pancreas T2∗ showed negative predictive value of 100% for cardiac iron.LGE sequences were acquired in 273 TM patients and 84 (30.77%) of them showed macroscopic myocardial fibrosis. Global pancreas T2∗ values were significantly lower in patients with fibrosis (7.38 ± 6.19 ms vs 11.91 ± 9.79 ms; P < 0.0001).Sixty‐four patients had at least one cardiac complication (arrhythmias, heart failure, pulmonary hyperthension, vascular disease). Patients with cardiac complications showed a significant lower global pancreas T2∗ (7.83 ± 5.61 ms vs 12.76 ± 10.34 ms; P = 0.024). Specifically, global pancreas T2∗ values were significantly lower in patients with heart failure as well as in patients with arrhythmias and all patients with one of these two diseases had a pathologic global pancreas T2∗ value (see Figure).Summary/Conclusion:Pancreatic iron is a strong predictor not only for cardiac iron, but also for cardiac complications supporting a more profound link between pancreatic iron and heart disease in TM.image