Seven-hundred and nine patients with thalassemia major who performed a baseline and a 1st follow-up CMR scan after 18 months were followed prospectively in order to evaluate the predictive value of changes in CMR parameters (myocardial iron, biventricular function, and replacement myocardial fibrosis) for cardiac complications. During a mean follow-up of 89.4±33.3 months, cardiac events (heart failure, arrhythmias, and pulmonary hypertension) were recorded in 7.1% of patients. In the univariate Cox regression analysis, cardiac iron clearance and replacement myocardial fibrosis were identified as univariate prognosticators but in the multivariate analysis only myocardial fibrosis remained an independent predictor factor.
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