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Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Myocardial deformation in patients with Beta-thalassemia major: a speckle tracking echocardiographic study
Yiu-fai Cheung1, Xue-cun Liang, Godfrey Chi-fung Chan
1Division of Paediatric Cardiology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China. xfcheung@hkucc.hku.hk
Insights
Patients with beta-thalassemia major show impaired myocardial deformation, particularly reduced early diastolic strain rates. These diastolic dysfunction rates correlate with myocardial iron overload, highlighting a key concern in managing this condition.
Area of Science:
- Cardiology
- Biomedical Engineering
- Hematology
Background:
- Myocardial deformation parameters are crucial indicators of ventricular function.
- Beta-thalassemia major patients are at risk for cardiac complications due to iron overload.
Purpose of the Study:
- To evaluate left ventricular myocardial deformation in patients with beta-thalassemia major.
- To investigate the relationship between myocardial deformation rates and iron load.
Main Methods:
- Speckle tracking echocardiography was used to assess longitudinal, circumferential, and radial myocardial deformation in 42 patients.
- Deformation rates were compared to 38 age-matched controls.
- Cardiac T2* magnetic resonance imaging quantified myocardial iron load.
Main Results:
- Patients exhibited increased global systolic radial strain but reduced longitudinal systolic strain rate.
- Significantly lower longitudinal and circumferential early diastolic strain rates were observed in patients compared to controls.
- Diastolic deformation rates showed a positive correlation with cardiac T2* values, indicating an inverse relationship with iron overload.
Conclusions:
- Beta-thalassemia major is associated with reduced longitudinal systolic and early diastolic strain rates, as well as circumferential early diastolic strain rates.
- Diastolic myocardial deformation is inversely proportional to myocardial iron accumulation in these patients.
Background:
Increasing data suggest that parameters of myocardial deformation are strong indices of ventricular systolic and diastolic function. We sought to determine myocardial deformation of the left ventricle and assess relationship of deformation rates with myocardial iron load in patients with beta-thalassemia major.
Methods:
The left ventricular longitudinal, circumferential, and radial myocardial deformation was determined using speckle tracking echocardiography in 42 thalassemia patients aged 24.4 +/- 6.4 years. The results were compared with those of 38 age-matched controls. The rates of longitudinal and circumferential deformation were correlated with cardiac T2* magnetic resonance findings.
Results:
Compared with controls, patients had significantly greater global systolic radial strain (P = 0.001), but similar global systolic longitudinal (P = 0.12) and circumferential strain (P = 0.84). On the other hand, patients had significantly lower longitudinal systolic strain rate (SR) (P = 0.019), longitudinal early diastolic SR (P = 0.036), and circumferential early diastolic SR (P = 0.04) than controls. The cardiac T2* findings correlated positively with longitudinal (r = 0.44, P = 0.004) and circumferential early diastolic SR (r = 0.37, P = 0.019), but not with the respective systolic SRs and left ventricular ejection fraction (all P > 0.05). Patients with iron overload (T2*< 20 msec), compared to those without, had significantly lower longitudinal (1.45 +/- 0.33/sec vs. 1.76 +/- 0.27/sec, P = 0.002) and circumferential (1.01 +/- 0.31/sec vs. 1.22 +/- 0.31/sec, P = 0.03) early diastolic SR.
Conclusions:
Patients with beta-thalassemia major have reduced longitudinal systolic SR, longitudinal early diastolic SR, and circumferential early diastolic SR. The rates of diastolic deformation in the longitudinal and circumferential dimensions are inversely related to myocardial iron overload.
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