{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T13:40:41Z","timestamp":1774878041690,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,1,27]],"date-time":"2023-01-27T00:00:00Z","timestamp":1674777600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Notwithstanding the improvement in therapies, patients affected by thalassemia major (TM) and intermedia (TI) are still at high risk of cardiac complications. This study aimed at evaluating the incidence and predictive factors for developing cardiac events in adult <jats:italic>\u03b2<\/jats:italic>\u2010TM and TI patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population and Methods<\/jats:title><jats:p>Data on diagnosis and clinical history were collected retrospectively; prospective data on new\u2010onset cardiac failure and arrhythmias, echocardiographic parameters, biochemical variables including non\u2010transferrin\u2010bound iron (NTBI) and labile plasma iron (LPI), magnetic resonance imaging (MRI) T2* measurement of hepatic and cardiac iron deposits, and iron chelation therapy were recorded during a 6\u2010year follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010seven patients, 29 TM and 8 TI, were included. At baseline, 8 TM patients and 1 TI patient had previously experienced a cardiac event (mainly heart failure). All patients were on chelation therapy and only 3 TM patients had mild\u2010to\u2010severe cardiac siderosis. During follow\u2010up, 11 patients (29.7%) experienced a new cardiac event. The occurrence of cardiac events was correlated to high LPI levels (OR 12.0, 95% CI 1.56\u201392.3, <jats:italic>p<\/jats:italic> .017), low mean pre\u2010transfusion haemoglobin (OR 0.21, 95% C.I. 0.051\u20130.761, <jats:italic>p<\/jats:italic> .21) and echocardiographic parameters suggestive of myocardial hypertrophy. Multivariate analysis disclosed high LPI and left ventricle mass index (LVMI) as independent variables significantly associated with cardiac events. Cardiac iron deposits measured by MRI T2* failed to predict cardiac events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>LPI, Hb levels and echocardiographic parameters assessing cardiac remodelling are associated with cardiac events in adult TM and TI patients. LPI might represent both a prognostic marker and a potential target for novel treatment strategies. Further studies are warranted to confirm our findings on larger populations.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.13954","type":"journal-article","created":{"date-parts":[[2023,1,16]],"date-time":"2023-01-16T17:28:44Z","timestamp":1673890124000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Labile plasma iron and echocardiographic parameters are associated with cardiac events in <i>\u03b2<\/i>\u2010thalassemic patients"],"prefix":"10.1111","volume":"53","author":[{"given":"Francesca","family":"Ferrara","sequence":"first","affiliation":[{"name":"Internal Medicine Unit and Centre for Hereditary Anemias ERN\u2013EuroBloodNet Center for Iron Disorders, Azienda Ospedaliero\u2013Universitaria di Modena\u2013Policlinico  Modena Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Coppi","sequence":"additional","affiliation":[{"name":"Cardiology Unit Azienda 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