{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T02:04:21Z","timestamp":1789524261357,"version":"build-2803163510"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,4,20]],"date-time":"2020-04-20T00:00:00Z","timestamp":1587340800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"The MIOT project receives \u201cno-profit support\u201d from industrial sponsorships (Chiesi Farmaceutici S.p.A., ApoPharma Inc., and Bayer)."}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Cardiac MRI plays a critical role in the management of thalassemic patients. No accurate biventricular reference values are available.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To establish the ranges for normal left ventricular (LV) and right ventricular (RV) volumes and ejection fraction (EF) and LV mass normalized to body surface area (BSA), age, and gender in a large cohort of well\u2010treated beta\u2010thalassemia major (\u03b2\u2010TM) patients without heart damage using a multiparametric MRI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Type<\/jats:title><jats:p>Retrospective\/cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>In all, 251 \u03b2\u2010TM patients with no known risk factors or cardiac disease, normal electrocardiogram, no macroscopic myocardial fibrosis, and all cardiac segments with T<jats:sub>2<\/jats:sub>*\u2009\u226520 msec, and 246 healthy subjects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Field Strength\/Sequence<\/jats:title><jats:p>1.5T\/cine steady\u2010state free precession (<jats:styled-content style=\"fixed-case\">SSFP)<\/jats:styled-content>, gradient\u2010echo <jats:styled-content style=\"fixed-case\">T<jats:sub>2<\/jats:sub><\/jats:styled-content>*, late gadolinium enhancement (<jats:styled-content style=\"fixed-case\">LGE) images<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Assessment<\/jats:title><jats:p>Biventricular end\u2010diastolic volume, end\u2010systolic volume, stroke volume, and LV mass were normalized to BSA (EDVI, ESVI, SVI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistical Tests<\/jats:title><jats:p>Comparisons between the two groups was performed with two\u2010samples <jats:italic>t<\/jats:italic>\u2010test or Wilcoxon's signed rank test. For more than two groups, one\u2010way analysis of variance (ANOVA) or a Kruskal\u2013Wallis test were applied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to controls, males with \u03b2\u2010TM showed significantlt higher LVEDVI in all the age groups, while for the other volumes the difference was significant only within one or more age groups. In females the volumes were comparable between \u03b2\u2010TM patients and healthy subjects in all the age groups. In the male \u03b2\u2010TM population we found a significant effect of age on LVEDVI (<jats:italic>P<\/jats:italic> = 0.017), LVESVI (<jats:italic>P<\/jats:italic> = 0.001), RVESVI (<jats:italic>P<\/jats:italic> = 0.029), and RVEF (<jats:italic>P<\/jats:italic> = 0.031), while for females none of the biventricular parameters were significantly different among the age groups (LVEDVI: <jats:italic>P<\/jats:italic> = 0.614; LVESVI: <jats:italic>P<\/jats:italic> = 0.449; LVSVI: <jats:italic>P<\/jats:italic> = 0.186; LV mass index: <jats:italic>P<\/jats:italic> = 0.071; LVEF: <jats:italic>P<\/jats:italic> = 0.059; RVEDVI: <jats:italic>P<\/jats:italic> = 0.374; RVESVI: <jats:italic>P<\/jats:italic> = 0.180; RVSVI: <jats:italic>P<\/jats:italic> = 0.206; RVEF: <jats:italic>P<\/jats:italic> = 0.057). In \u03b2\u2010TM patients all biventricular volume indexes as well as the LV mass index were significantly larger in males than in females (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001 in all cases). The LV and the RV EF were comparable between the sexes (<jats:italic>P<\/jats:italic> = 0.568 and <jats:italic>P<\/jats:italic> = 0.268, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>Appropriate \u201cnormal\u201d reference ranges normalized to BSA, sex, and age are recommended to avoid misdiagnosis of cardiomyopathy in \u03b2\u2010TM patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4<\/jats:p><\/jats:sec><jats:sec><jats:title>Technical Efficacy Stage<\/jats:title><jats:p>2<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.27169","type":"journal-article","created":{"date-parts":[[2020,4,20]],"date-time":"2020-04-20T20:16:10Z","timestamp":1587413770000},"page":"61-70","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Biventricular Reference Values by Body Surface Area, Age, and Gender in a Large Cohort of Well\u2010Treated Thalassemia Major Patients Without Heart Damage Using a Multiparametric <scp>CMR<\/scp> Approach"],"prefix":"10.1002","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2284-8585","authenticated-orcid":false,"given":"Antonella","family":"Meloni","sequence":"first","affiliation":[{"name":"Magnetic Resonance Imaging Unit Fondazione G. Monasterio CNR\u2010Regione Toscana  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Righi","sequence":"additional","affiliation":[{"name":"Diagnostica per Immagini e Radiologia Interventistica Ospedale del Delta  Lagosanto Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimiliano","family":"Missere","sequence":"additional","affiliation":[{"name":"Dipartimento di Immagini Fondazione di Ricerca e Cura \u201cGiovanni Paolo II\u201d  Campobasso Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Renne","sequence":"additional","affiliation":[{"name":"Struttura Complessa di Cardioradiologia\u2010UTIC, Presidio Ospedaliero \u201cGiovanni Paolo II\u201d  Lamezia Terme Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicol\u00f2","family":"Schicchi","sequence":"additional","affiliation":[{"name":"Dipartimento di Radiologia Azienda Ospedaliero\u2010Universitaria Ospedali Riuniti \"Umberto I\u2010Lancisi\u2010Salesi\"  Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Rita","family":"Gamberini","sequence":"additional","affiliation":[{"name":"Dipartimento della Riproduzione e dell'Accrescimento Day Hospital della Talassemia e delle Emoglobinopatie Azienda Ospedaliero\u2010Universitaria Arcispedale \"S. Anna\"  Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liana","family":"Cuccia","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Complessa Ematologia con Talassemia, ARNAS Civico \u201cBenfratelli\u2010Di Cristina\u201d  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Lisi","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Dipartimentale Talassemia, Presidio Ospedaliero Garibaldi\u2010Centro\u2010ARNAS Garibaldi  Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Spasiano","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Semplice Dipartimentale Malattie Rare del Globulo Rosso, Azienda Ospedaliera di Rilievo Nazionale \u201cA. Cardarelli\u201d  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Grazia","family":"Roberti","sequence":"additional","affiliation":[{"name":"Servizio Trasfusionale, Azienda Ospedaliero\u2010Universitaria OO.RR. Foggia  Foggia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Zuccarelli","sequence":"additional","affiliation":[{"name":"U.O. Medicina trasfusionale Presidio Ospedaliero Sirai  Carbonia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1672-5308","authenticated-orcid":false,"given":"Lamia","family":"Ait\u2010Ali","sequence":"additional","affiliation":[{"name":"Institute of Clinical Physiology, National Research Council  Massa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierluigi","family":"Festa","sequence":"additional","affiliation":[{"name":"Magnetic Resonance Imaging Unit Fondazione G. 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