Detection of Left Ventricular Regional Function in Asymptomatic Children with beta-Thalassemia Major by Longitudinal Strain and Strain Rate Imaging
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Published on: February 12, 2011
Ali Bay1, Osman Başpınar2, Göksel Leblebisatan3
1Gaziantep University Medical Faculty, Department of Pediatric Hematology, Gaziantep, Turkey.
Insights
Pediatric beta-thalassemia major patients show altered cardiac function. Left ventricle volume and mass index may be sensitive indicators of early cardiac changes, while strain imaging may reveal later iron overload effects.
Area of Science:
- Cardiology
- Pediatrics
- Hematology
Background:
- Iron overload is a primary cause of cardiac failure in beta-thalassemia major.
- Early detection of myocardial dysfunction is crucial for managing pediatric patients.
Purpose of the Study:
- To assess myocardial function in children with beta-thalassemia major.
- Utilize standard echocardiography and strain rate imaging for evaluation.
Main Methods:
- Evaluated 48 children with beta-thalassemia major and 22 healthy controls.
- Employed conventional echocardiography, tissue velocity imaging, and left ventricular strain/strain rate imaging.
Main Results:
- Beta-thalassemia patients exhibited larger left ventricular end-systolic diameter, volumes, and mass index.
- Mitral early/late diastolic flow velocity ratio was elevated in patients.
- Left ventricular basal lateral wall strain and strain rate were higher in patients compared to controls.
Conclusions:
- Superior strain and strain rate imaging indicate regional systolic function.
- Left ventricle volume and mass index may be more sensitive in childhood.
- Adult strain/strain rate imaging may decrease with critical iron overload.
Objective:
Cardiac failure due to iron overload remains the most common cause of death in patients with beta-thalassemia major. This study aimed to evaluate myocardial function in children with beta-thalassemia major using standard echocardiography technique and strain rate imaging.
Materials And Methods:
Conventional echocardiographic analysis, tissue velocity imaging, and strain/strain rate imaging of the left ventricle were evaluated in 48 children with beta-thalassemia major (19 girls, 29 boys; 8.39±4.05 years) and 22 healthy children (11 girls, 11 boys; 8±3.72 years).
Results:
Conventional echocardiographic examinations revealed that beta-thalassemia patients had larger left ventricular end-systolic diameter, end-diastolic and end-systolic volume, left ventricular mass index, and mitral early/late diastolic flow velocity ratio (p<0.05). Strain and strain rate imaging study of the basal lateral wall of the left ventricle was higher in patients than in controls, at p=0.035 and p=0.008, respectively.
Conclusion:
We found that superior systolic strain and strain rate imaging of the left ventricle indicated the presence of regional systolic function in the left ventricular wall. We suggest that left ventricle volume and mass index parameters might be more sensitive than the other conventional and strain/strain rate imaging parameters during childhood. However, the adulthood strain and strain rate imaging values may be lower than controls, exceeding the critical level of iron overload.
Conflict Of Interest:
None declared.
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