Diagnosis of iron overload cardiomyopathy:

Diagnosis of iron overload cardiomyopathy:

Iron overload is considered when plasma transferrin saturation is >55% and serum ferritin >200 ng/mL in women or 300 ng/mL in men .

Liver biopsy is the gold standard for diagnosing haemochromatosis, but cardiac biopsy may be negative due to the patchy nature of the disease.

Echocardiography may reveal restrictive or dilated pattern.

Cardiac magnetic resonance is the only non-invasive method, with the potential to assess quantitatively myocardial iron load by using techniques, such as special small magnetic fields called gradients (gradient echo-GE) at specific time intervals (echo time-TE).
The time constant of decay for GE-induced relaxation time is known as T2.

The following stratification scheme has been proposed:
◆ T 2* >20 ms indicates low risk for the imminent development of congestive heart failure
◆ T2* = 10–20 ms indicates intermediate risk of cardiac failure
◆ T2* <10 ms indicates high risk that needs intensification of chelation therapy.