Combinatorial approach to treat iron overload cardiomyopathy in pediatric patients with thalassemia-major: A systematic review and meta-analysis

Figure 3 Forest plot showing changes in cardiac T2, myocardial iron concentration, and liver iron concentration. A: Forest plot showing changes in cardiac T2 with adding amlodipine to chelation therapy compared to chelation therapy alone, from baseline to follow-up. The analysis revealed a significant improvement in cardiac T2 in the amlodipine group, with a mean difference of 2.79 ms and a 95% confidence interval (CI) of 0.34 to 5.24 ms. The heterogeneity between the studies, assessed using the I² statistic, was 0%, indicating no variability in the outcome across the included studies; B: The forest plot illustrates changes in myocardial iron concentration between the amlodipine group and the control from baseline to follow-up. The analysis demonstrated a significant decrease in myocardial iron concentration within the amlodipine group, with a mean reduction of 0.31 and a 95%CI ranging from -0.38 to -0.25. Additionally, the heterogeneity among the studies, evaluated through the I² statistic, was 0%, indicating no variability in outcomes across the included studies; C: The forest plot illustrates the changes in liver iron concentration observed in the amlodipine group compared to the control group from baseline to follow-up. The analysis revealed a non-significant reduction in liver iron concentration within the amlodipine group, with a mean decrease of 0.04 and a 95%CI ranging from -0.33 to 0.24. Furthermore, the heterogeneity among the studies, assessed using the I² statistic, was determined to be 0%, indicating no variability in the outcomes across the studies included. CI: Confidence interval.