Journal
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
Volume 56, Issue 13, Pages 1001-1012Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2010.03.083
Keywords
calcium channel blockers; chelation; hemochromatosis; hemosiderosis; iron overload cardiomyopathy; T2*MRI
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Funding
- NHLBI/NIH
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The prevalence of iron overload cardiomyopathy (IOC) is increasing. The spectrum of symptoms of IOC is varied. Early in the disease process, patients may be asymptomatic, whereas severely overloaded patients can have terminal heart failure complaints that are refractory to treatment. It has been shown that early recognition and intervention may alter outcomes. Biochemical markers and tissue biopsy, which have traditionally been used to diagnose and guide therapy, are not sensitive enough to detect early cardiac iron deposition. Newer diagnostic modalities such as magnetic resonance imaging are noninvasive and can assess quantitative cardiac iron load. Phlebotomy and chelating drugs are suboptimal means of treating IOC; hence, the roles of gene therapy, hepcidin, and calcium channel blockers are being actively investigated. There is a need for the development of clinical guidelines in order to improve the management of this emerging complex disease. (J Am Coll Cardiol 2010; 56: 1001-12) (C) 2010 by the American College of Cardiology Foundation
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