Lack of correlation between iron overload cardiac dysfunction and needle liver biopsy iron concentration

In 58 patients with transfusion dependent anemia, we compared cardiac function, as assessed by gated pooled cardiac scan at rest and during exercise stress, with liver iron concentrations (LIC) as determined by adequate biopsy samples. There was no relationship between LIC and cardiac function and deaths occurred in patients with LIC levels below those that are usually associated with cardiac death. LIC should not be used as a surrogate to determine risk of cardiac complications but purely for management of the hepatic iron load. Other methods, particularly magnetic resonance imaging, should be used to assess cardiac iron overload.