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Assessment of LV diastolic function in patients with beta-thalassemia major with special reference to E/Eann ratio

Gurunath P Parale1, Swapnil S Pawar, Vinay S Tapare

  • 1Department of Medicine, Ashwini Cooperative Hospital, Maharashtra, India. parale8@yahoo.com

Journal of Pediatric Hematology/Oncology
|January 7, 2009
PubMed

Insights

Beta-thalassemia major patients show diastolic dysfunction, indicated by prolonged E deceleration time (Edec) and increased E/Eann ratio, even before systolic dysfunction appears. This cardiac issue is detected using pulsed wave tissue Doppler imaging.

Area of Science:

  • Cardiology
  • Hematology
  • Medical Imaging

Background:

  • Beta-thalassemia major is a severe inherited blood disorder requiring lifelong transfusions.
  • Cardiac complications, particularly left ventricular dysfunction, are a significant cause of morbidity and mortality in these patients.
  • Early detection of cardiac changes is crucial for timely intervention and improved outcomes.

Purpose of the Study:

  • To evaluate left ventricular (LV) diastolic and systolic function in patients with beta-thalassemia major.
  • To assess the utility of pulsed wave tissue Doppler imaging (TDI) in detecting cardiac abnormalities in this population.
  • To investigate the relationship between serum ferritin levels and diastolic dysfunction.

Main Methods:

  • A comparative study involving 30 patients with beta-thalassemia major and 30 age- and sex-matched healthy controls.
  • Left ventricular function assessed using echocardiography parameters: ejection fraction, mitral valve E/A ratio, E deceleration time (Edec), isovolumic relaxation time, and E/Eann ratio.
  • Serum ferritin levels were measured to assess iron overload.

Main Results:

  • Patients with beta-thalassemia major exhibited significantly prolonged Edec (177.66+/-40.73 vs. 138.5, P<0.001) and increased E/Eann ratio (9.46+/-1.5 vs. 6.16+/-2.4, P<0.0001) compared to controls, indicating diastolic dysfunction.
  • No significant differences were observed in ejection fraction or mitral valve E/A ratio between the groups.
  • Elevated serum ferritin levels (8370.85+/-2660.35) were noted in patients, but no correlation was found with the severity of diastolic dysfunction (r=0.148, P=0.258).

Conclusions:

  • Diastolic dysfunction, as evidenced by prolonged Edec and elevated E/Eann ratio, is prevalent in patients with beta-thalassemia major.
  • Diastolic dysfunction appears to precede systolic dysfunction in this patient group.
  • Pulsed wave tissue Doppler imaging is a valuable tool for assessing cardiac function in beta-thalassemia major.
Abstract

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