TY - JOUR TI - Correlation of NT-proBNP levels and cardiac iron concentration in patients with transfusion-dependent thalassemia major AU - Delaporta, Polyxeni AU - Kattamis, Antonios AU - Apostolakou, Filia and AU - Boiu, Sorina AU - Bartzeliotou, Anastasia AU - Tsoukas, Evangelos and AU - Papassotiriou, Ioannis JO - BLOOD CELLS MOLECULES AND DISEASES PY - 2013 VL - 50 TODO - 1 SP - 20-24 PB - ACADEMIC PRESS INC ELSEVIER SCIENCE SN - 1079-9796 TODO - 10.1016/j.bcmd.2012.09.002 TODO - Thalassemia major; NT-proBNP; Heart failure; Cardiac iron concentration TODO - Iron-induced cardiotoxicity remains the leading cause of morbidity and mortality in patients with transfusion-dependent beta-thalassemia major. Heart failure in these patients, which may be reversible but has a poor prognosis, is characterized by myocardial iron deposition-related early diastolic dysfunction. Amino-terminal pro-brain natriuretic peptide (NT-proBNP) is a sensitive biomarker for the detection of asymptomatic left ventricular dysfunction. In this study, we prospectively evaluated plasma NT-proBNP levels in 187 adult patients aged 19-54 years with beta-TM. Possible correlations with the proposed recently cardiac iron concentration based on an equation derived from heart T2* assessment by MRI: [Fe] = 45.0 x [T2*](-1.22) with [Fe] in milligrams per gram dry weight and T2* in milliseconds were explored. We found that: 143 patients had no cardiac hemosiderosis, defined as [Fe]<1.1 mg/g dry weight, corresponding to T2*>20 ms and 44 patients had cardiac hemosiderosis, defined as [Fe]>1.2 mg/g dry weight. The main results of the study showed that: a) NT-proBNP levels were markedly increased in thalassemic patients (152.2 +/- 190.1 pg/mL, ranged from 6.0 to 1336.0 pg/mL compared to normal control levels 40.1 +/- 19.7 pg/ml, p<0.001, b) NT-proBNP levels were significantly higher in patients with cardiac hemosiderosis compared to patients without cardiac hemosiderosis (185.1 +/- 78.0 vs 128.9 +/- 20.2 pg/mL, p<0.05), c) NT-proBNP levels correlated with [Fe] values (r = 0.387, p<0.001). This correlation was significant in patients with cardiac hemosiderosis (r = 0.520, p<0.001), but not in patients without cardiac hemosiderosis (p>0.1), and d) no significant correlation was found between NT-proBNP levels and left ventricular ejection fraction values, (p>0.3). Our study demonstrated for first time the significant association of NT-proBNP levels and cardiac iron concentration in patients with beta-thalassemia major linking blood chemistry and imaging techniques. Multicenter studies of these parameters during iron chelation therapies are needed to validate their association and further exploit its clinical use. (C) 2012 Elsevier Inc. All rights reserved. ER -