Safety of cardiovascular magnetic resonance gadolinium chelates contrast agents in patients with hemoglobinopathies

Myocardial fibrosis/necrosis has been documented by histological and Cardiovascular Magnetic Resonance (CMR) studies in patients with haemoglobinopathies. The delayed enhancement cardiovascular magnetic resonance technique with intravenous administration of gadolinium (Gd) chelate contrast agents is the only validated approach for detecting myocardial fibrosis non-invasively. Recently, the safety of Gd chelates has been brought into question and a possible link with nephrogenic systemic fibrosis has emerged. We investigated the possible risks of Gd chelates in a large cohort of patients with haemolobinopathies, generally characterized by heavy co-morbidity due to iron overload. In these patients, Gd chelates have been shown to be safe and well tolerated, with a risk comparable to that of the general population.