Spatial repolarization heterogeneity detected by magnetocardiography correlates with cardiac iron overload and adverse cardiac events in beta-thalassemia major

Chun An Chen, Meng Yao Lu, Shinn Forng Peng, Kai Hsin Lin, Hsiu Hao Chang, Yung Li Yang, Shiann Tarng Jou, Dong Tsamn Lin, Yen Bin Liu, Herng Er Horng, Hong Chang Yang, Jou Kou Wang, Mei Hwan Wu, Chau Chung Wu

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Abstract

Background: Patients with transfusion-dependent beta-thalassemia major (TM) are at risk for myocardial iron overload and cardiac complications. Spatial repolarization heterogeneity is known to be elevated in patients with certain cardiac diseases, but little is known in TM patients. The purpose of this study was to evaluate spatial repolarization heterogeneity in patients with TM, and to investigate the relationships between spatial repolarization heterogeneity, cardiac iron load, and adverse cardiac events. Methods and Results: Fifty patients with TM and 55 control subjects received 64-channel magnetocardiography (MCG) to determine spatial repolarization heterogeneity, which was evaluated by a smoothness index of QTc (SI-QTc), a standard deviation of QTc (SD-QTc), and a QTc dispersion. Left ventricular function and myocardial T2* values were assessed by cardiac magnetic resonance. Patients with TM had significantly greater SI-QT c, SD-QTc, and QTc dispersion compared to the control subjects (all p values<0.001). Spatial repolarization heterogeneity was even more pronounced in patients with significant iron overload (T2*<20 ms, n = 20) compared to those with normal T2*(all p values<0.001). Loge cardiac T2* correlated with SI-QT c (r = -0.609, p<0.001), SD-QTc (r = -0.572, p<0.001), and QTc dispersion (r = -0.622, p<0.001), while all these indices had no relationship with measurements of the left ventricular geometry or function. At the time of study, 10 patients had either heart failure or arrhythmia. All 3 indices of repolarization heterogeneity were related to the presence of adverse cardiac events, with areas under the receiver operating characteristic curves (ranged between 0.79 and 0.86), similar to that of cardiac T2*. Conclusions: Multichannel MCG demonstrated that patients with TM had increased spatial repolarization heterogeneity, which is related to myocardial iron load and adverse cardiac events.

Original languageEnglish
Article numbere86524
JournalPloS one
Volume9
Issue number1
DOIs
Publication statusPublished - 2014 Jan 27

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Magnetocardiography
thalassemia
iron overload
Iron Overload
beta-Thalassemia
Iron
Magnetic resonance
iron
Geometry
Time and Motion Studies
arrhythmia
heart diseases
heart failure
Left Ventricular Function
ROC Curve
Cardiac Arrhythmias
Heart Diseases
Magnetic Resonance Spectroscopy
Heart Failure

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

Cite this

Spatial repolarization heterogeneity detected by magnetocardiography correlates with cardiac iron overload and adverse cardiac events in beta-thalassemia major. / Chen, Chun An; Lu, Meng Yao; Peng, Shinn Forng; Lin, Kai Hsin; Chang, Hsiu Hao; Yang, Yung Li; Jou, Shiann Tarng; Lin, Dong Tsamn; Liu, Yen Bin; Horng, Herng Er; Yang, Hong Chang; Wang, Jou Kou; Wu, Mei Hwan; Wu, Chau Chung.

In: PloS one, Vol. 9, No. 1, e86524, 27.01.2014.

Research output: Contribution to journalArticle

Chen, CA, Lu, MY, Peng, SF, Lin, KH, Chang, HH, Yang, YL, Jou, ST, Lin, DT, Liu, YB, Horng, HE, Yang, HC, Wang, JK, Wu, MH & Wu, CC 2014, 'Spatial repolarization heterogeneity detected by magnetocardiography correlates with cardiac iron overload and adverse cardiac events in beta-thalassemia major', PloS one, vol. 9, no. 1, e86524. https://doi.org/10.1371/journal.pone.0086524
Chen, Chun An ; Lu, Meng Yao ; Peng, Shinn Forng ; Lin, Kai Hsin ; Chang, Hsiu Hao ; Yang, Yung Li ; Jou, Shiann Tarng ; Lin, Dong Tsamn ; Liu, Yen Bin ; Horng, Herng Er ; Yang, Hong Chang ; Wang, Jou Kou ; Wu, Mei Hwan ; Wu, Chau Chung. / Spatial repolarization heterogeneity detected by magnetocardiography correlates with cardiac iron overload and adverse cardiac events in beta-thalassemia major. In: PloS one. 2014 ; Vol. 9, No. 1.
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abstract = "Background: Patients with transfusion-dependent beta-thalassemia major (TM) are at risk for myocardial iron overload and cardiac complications. Spatial repolarization heterogeneity is known to be elevated in patients with certain cardiac diseases, but little is known in TM patients. The purpose of this study was to evaluate spatial repolarization heterogeneity in patients with TM, and to investigate the relationships between spatial repolarization heterogeneity, cardiac iron load, and adverse cardiac events. Methods and Results: Fifty patients with TM and 55 control subjects received 64-channel magnetocardiography (MCG) to determine spatial repolarization heterogeneity, which was evaluated by a smoothness index of QTc (SI-QTc), a standard deviation of QTc (SD-QTc), and a QTc dispersion. Left ventricular function and myocardial T2* values were assessed by cardiac magnetic resonance. Patients with TM had significantly greater SI-QT c, SD-QTc, and QTc dispersion compared to the control subjects (all p values<0.001). Spatial repolarization heterogeneity was even more pronounced in patients with significant iron overload (T2*<20 ms, n = 20) compared to those with normal T2*(all p values<0.001). Loge cardiac T2* correlated with SI-QT c (r = -0.609, p<0.001), SD-QTc (r = -0.572, p<0.001), and QTc dispersion (r = -0.622, p<0.001), while all these indices had no relationship with measurements of the left ventricular geometry or function. At the time of study, 10 patients had either heart failure or arrhythmia. All 3 indices of repolarization heterogeneity were related to the presence of adverse cardiac events, with areas under the receiver operating characteristic curves (ranged between 0.79 and 0.86), similar to that of cardiac T2*. Conclusions: Multichannel MCG demonstrated that patients with TM had increased spatial repolarization heterogeneity, which is related to myocardial iron load and adverse cardiac events.",
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AU - Chen, Chun An

AU - Lu, Meng Yao

AU - Peng, Shinn Forng

AU - Lin, Kai Hsin

AU - Chang, Hsiu Hao

AU - Yang, Yung Li

AU - Jou, Shiann Tarng

AU - Lin, Dong Tsamn

AU - Liu, Yen Bin

AU - Horng, Herng Er

AU - Yang, Hong Chang

AU - Wang, Jou Kou

AU - Wu, Mei Hwan

AU - Wu, Chau Chung

PY - 2014/1/27

Y1 - 2014/1/27

N2 - Background: Patients with transfusion-dependent beta-thalassemia major (TM) are at risk for myocardial iron overload and cardiac complications. Spatial repolarization heterogeneity is known to be elevated in patients with certain cardiac diseases, but little is known in TM patients. The purpose of this study was to evaluate spatial repolarization heterogeneity in patients with TM, and to investigate the relationships between spatial repolarization heterogeneity, cardiac iron load, and adverse cardiac events. Methods and Results: Fifty patients with TM and 55 control subjects received 64-channel magnetocardiography (MCG) to determine spatial repolarization heterogeneity, which was evaluated by a smoothness index of QTc (SI-QTc), a standard deviation of QTc (SD-QTc), and a QTc dispersion. Left ventricular function and myocardial T2* values were assessed by cardiac magnetic resonance. Patients with TM had significantly greater SI-QT c, SD-QTc, and QTc dispersion compared to the control subjects (all p values<0.001). Spatial repolarization heterogeneity was even more pronounced in patients with significant iron overload (T2*<20 ms, n = 20) compared to those with normal T2*(all p values<0.001). Loge cardiac T2* correlated with SI-QT c (r = -0.609, p<0.001), SD-QTc (r = -0.572, p<0.001), and QTc dispersion (r = -0.622, p<0.001), while all these indices had no relationship with measurements of the left ventricular geometry or function. At the time of study, 10 patients had either heart failure or arrhythmia. All 3 indices of repolarization heterogeneity were related to the presence of adverse cardiac events, with areas under the receiver operating characteristic curves (ranged between 0.79 and 0.86), similar to that of cardiac T2*. Conclusions: Multichannel MCG demonstrated that patients with TM had increased spatial repolarization heterogeneity, which is related to myocardial iron load and adverse cardiac events.

AB - Background: Patients with transfusion-dependent beta-thalassemia major (TM) are at risk for myocardial iron overload and cardiac complications. Spatial repolarization heterogeneity is known to be elevated in patients with certain cardiac diseases, but little is known in TM patients. The purpose of this study was to evaluate spatial repolarization heterogeneity in patients with TM, and to investigate the relationships between spatial repolarization heterogeneity, cardiac iron load, and adverse cardiac events. Methods and Results: Fifty patients with TM and 55 control subjects received 64-channel magnetocardiography (MCG) to determine spatial repolarization heterogeneity, which was evaluated by a smoothness index of QTc (SI-QTc), a standard deviation of QTc (SD-QTc), and a QTc dispersion. Left ventricular function and myocardial T2* values were assessed by cardiac magnetic resonance. Patients with TM had significantly greater SI-QT c, SD-QTc, and QTc dispersion compared to the control subjects (all p values<0.001). Spatial repolarization heterogeneity was even more pronounced in patients with significant iron overload (T2*<20 ms, n = 20) compared to those with normal T2*(all p values<0.001). Loge cardiac T2* correlated with SI-QT c (r = -0.609, p<0.001), SD-QTc (r = -0.572, p<0.001), and QTc dispersion (r = -0.622, p<0.001), while all these indices had no relationship with measurements of the left ventricular geometry or function. At the time of study, 10 patients had either heart failure or arrhythmia. All 3 indices of repolarization heterogeneity were related to the presence of adverse cardiac events, with areas under the receiver operating characteristic curves (ranged between 0.79 and 0.86), similar to that of cardiac T2*. Conclusions: Multichannel MCG demonstrated that patients with TM had increased spatial repolarization heterogeneity, which is related to myocardial iron load and adverse cardiac events.

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