Early detection of myocardial dysfunction in children with beta-thalassaemia major

Abstract

To evaluate left and right ventricular myocardial performance using pulsed-tissue Doppler imaging (TDI) and its relation to BNP levels in patients with beta-thalassaemia major (beta-TM). We enrolled 36 thalassaemic patients (21 male, 15 female; mean age: 14.2 +/- 4.1 years) with normal left ventricular systolic and diastolic functions with conventional echocardiography and 30 healthy control subjects (18 male, 12 female, and 12.5 +/- 4.2 years). Myocardial performance indexes (MPI) of left ventricular (LV) lateral wall, interventricular septum (IVS) and right ventricular (RV) lateral wall were calculated with TDI. Plasma BNP levels were measured in all patients. MPIs and other echocardiographic parameters of patients with beta-TM were compared with control group. All the patients' plasma BNP levels were within normal limits. There were no differences between conventional echocardiographic parameters of patients and control group. MPI of LV, IVS, and RV of patients were significantly higher than control group (P = 0.01, and P < 0.01, and P < 0.001, respectively). Our study confirms that MPI obtained by TDI seems to be an early sensitive parameter of cardiac dysfunction in beta-TM. We concluded that MPI obtained by TDI may be an adjunctive parameter to conventional echocardiography for detecting early myocardial damage.

The efficacy of tissue Doppler imaging in predicting myocardial iron load in patients with beta-thalassemia major: correlation with T2* cardiovascular magnetic resonance

“…Tissue Doppler imaging can detect regional systolic and diastolic myocardial dysfunction earlier than global dysfunction in thalassemia patients [8][9][10][11][12][13]. Our results were in accordance with previous studies; [8].…”

“…In accordance to previous studies, in our study patients with TM had larger LVEDD and LVESD compared to controls [1,9,13,17,18]. The increase in diameter of heart chambers in thalassemia patients are attributed to high cardiac output state secondary to chronic anemia and hypoxia.…”

“…Therefore, T2* MR is still unsuitable for screening of patients with TM. Previous studies have reported that tissue Doppler imaging (TDI) can detect early myocardial dysfunction related to iron overload [8][9][10][11][12][13].…”

Iron overload in polytransfused patients without heart failure is associated with subclinical alterations of systolic left ventricular function using cardiovascular magnetic resonance tagging

“…Other studies [21-27] employing tissue Doppler echocardiography, described reductions of systolic tissue Doppler velocities in patients with chronic iron overload. Hamdy et al [25] also reported reduced systolic strains using tissue Doppler echocardiography in patients with iron overload.…”

Echocardiographic evaluation of systolic and diastolic heart function in patients suffering from beta-thalassemia major aged 5-10 years at the Zahedan Research Center for

“…There have been new studies on thalassemic patients comparing echocardiographic parameters of MPI by pulsed tissue Doppler imaging and parameters derived from conventional echocardiography but none of these studies have been performed on asymptomatic children below ten years old (13).…”