Iron Overload Cardiomyopathy: Better Understanding of an Increasing Disorder

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 sho...

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Bibliographic Details
Published in:Journal of the American College of Cardiology 2010-09, Vol.56 (13), p.1001-1012
Main Authors: GUJJA, Pradeep, ROSING, Douglas R, TRIPODI, Dorothy J, SHIZUKUDA, Yukitaka
Format: Article
Language:English
Subjects:
Biological and medical sciences
Biomarkers - blood
Biopsy
Blood
Cardiology
Cardiology. Vascular system
Cardiomyopathies - blood
Cardiomyopathies - diagnosis
Cardiomyopathies - etiology
Cardiomyopathies - therapy
Cardiomyopathy
Critical Pathways
Echocardiography
Free radicals
Heart
Heart failure
Homeostasis
Humans
Iron - physiology
Iron Overload - blood
Iron Overload - complications
Iron Overload - diagnosis
Iron Overload - therapy
Ischemia
Liver diseases
Magnetic Resonance Imaging
Medical sciences
Metabolic diseases
Metals (hemochromatosis...)
Mortality
Mutation
Myocarditis. Cardiomyopathies
Myocardium - pathology
Other metabolic disorders
Rodents
Sickle cell disease
Tomography, X-Ray Computed
Transplants & implants
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Description
Summary: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.
ISSN:0735-1097
1558-3597
DOI:10.1016/j.jacc.2010.03.083