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Title: | Noninvasive imaging estimation of myocardial iron repletion following administration of intravenous iron: the myocardial-iron trial |
Author: | Nuñez, Julio Miñana, Gema Cardells, Ingrid Palau, Patricia Llàcer, Pau Fácila, Lorenzo Almenar, Luis López-Lereu, Maria P. Monmeneu, Jose V. Amiguet, Martina González, Jessika Serrano, Alicia Montagud, Vicente López Vilella, Raquel Valero, Ernesto García-Blas, Sergio Bodí, Vicent Espriella-Juan, Rafael de la Lupón, Josep Navarro Pérez, Jorge Górriz, José Luis Sanchis Forés, Juan Chorro, Francisco J. Comín Colet, Josep Bayés Genís, Antoni Myocardial‐IRON Investigators |
Keywords: | Anèmia Ferro Ressonància magnètica Miocardi Anemia Iron Magnetic resonance Myocardium |
Issue Date: | 13-Feb-2020 |
Publisher: | American Heart Association |
Abstract: | Background: intravenous ferric carboxymaltose (FCM) improves symptoms, functional capacity, and quality of life in heart failure and iron deficiency. The mechanisms underlying these effects are not fully understood. The aim of this study was to examine changes in myocardial iron content after FCM administration in patients with heart failure and iron deficiency using cardiac magnetic resonance. Methods and Results: fifty‐three stable heart failure and iron deficiency patients were randomly assigned 1:1 to receive intravenous FCM or placebo in a multicenter, double‐blind study. T2* and T1 mapping cardiac magnetic resonance sequences, noninvasive surrogates of intramyocardial iron, were evaluated before and 7 and 30 days after randomization using linear mixed regression analysis. Results are presented as least‐square means with 95% CI. The primary end point was the change in T2* and T1 mapping at 7 and 30 days. Median age was 73 (65-78) years, with N‐terminal pro‐B‐type natriuretic peptide, ferritin, and transferrin saturation medians of 1690 pg/mL (1010-2828), 63 ng/mL (22-114), and 15.7% (11.0-19.2), respectively. Baseline T2* and T1 mapping values did not significantly differ across treatment arms. On day 7, both T2* and T1 mapping (ms) were significantly lower in the FCM arm (36.6 [34.6-38.7] versus 40 [38-42.1], P=0.025; 1061 [1051-1072] versus 1085 [1074-1095], P=0.001, respectively). A similar reduction was found at 30 days for T2* (36.3 [34.1-38.5] versus 41.1 [38.9-43.4], P=0.003), but not for T1 mapping (1075 [1065-1085] versus 1079 [1069-1089], P=0.577). Conclusions: in patients with heart failure and iron deficiency, FCM administration was associated with changes in the T2* and T1 mapping cardiac magnetic resonance sequences, indicative of myocardial iron repletion. |
Note: | Reproducció del document publicat a: https://doi.org/10.1161/JAHA.119.014254 |
It is part of: | Journal of the American Heart Association, 2020, vol. 9, num. 4, p. e014254 |
URI: | https://hdl.handle.net/2445/177736 |
Related resource: | https://doi.org/10.1161/JAHA.119.014254 |
ISSN: | 2047-9980 |
Appears in Collections: | Articles publicats en revistes (Ciències Clíniques) |
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