Purging iron from the heart

Chaim Hershko, Maria D. Cappellini, Renzo Galanello, Antonio Piga, Gianni Tognoni, Giuseppe Masera

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)545-551
Number of pages7
JournalBritish Journal of Haematology
Volume125
Issue number5
DOIs
Publication statusPublished - Jun 1 2004

Keywords

  • Deferiprone
  • Desferrioxamine
  • Haemosiderosis
  • Heart
  • Iron chelation

ASJC Scopus subject areas

  • Hematology

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  • Cite this

    Hershko, C., Cappellini, M. D., Galanello, R., Piga, A., Tognoni, G., & Masera, G. (2004). Purging iron from the heart. British Journal of Haematology, 125(5), 545-551. https://doi.org/10.1111/j.1365-2141.2004.04946.x