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[Echocardiographic study at rest and during effort in adult asymptomatic thalassemic patients]
Insights
Young patients with thalassemia major (TM) show cardiac volume overload and impaired systolic function during exercise, despite regular blood transfusions and chelation therapy. This indicates subclinical cardiac changes in asymptomatic individuals.
Area of Science:
- Cardiology
- Hematology
- Pediatrics
Context:
- Thalassemia major (TM) patients often develop cardiac complications.
- Early detection of cardiac dysfunction is crucial for managing TM.
- This study investigates cardiac function in asymptomatic young TM patients.
Purpose:
- To assess cardiac structure and function in young, asymptomatic TM patients.
- To evaluate the impact of regular transfusion-chelation therapy on cardiac performance.
- To determine if subclinical cardiac changes occur during exercise stress.
Summary:
- Echocardiography was performed on 21 young TM patients and 24 controls at rest and during exercise.
- TM patients exhibited increased left ventricular (LV) dimensions and mass at rest.
- During exercise, TM patients showed a blunted increase in LV fractional shortening (FS), indicating impaired systolic function.
Impact:
- Asymptomatic young TM patients exhibit cardiac volume overload and impaired systolic function during exercise.
- These findings highlight the need for continuous cardiac monitoring in TM patients.
- Early identification of cardiac changes can guide therapeutic interventions and improve long-term outcomes.
Abstract:
An echocardiographic study was performed in 21 young patients with thalassemia major (TM, age 16-22 years), with no cardiac symptoms, and in 24 age-matched normals (N) at rest and during sitting bicycle exercise (EX). All TM were receiving blood transfusions regularly to maintain hemoglobin level above 11 g/dl and subcutaneous infusion of desferrioxamine (40 mg/Kg/day) to reduce hemosiderosis. At rest, in comparison to N, TM showed a significant increase in LV end-diastolic dimension (EDD), septal, posterior wall thickness and mass, whereas wall thickness to EDD ratio and LV fractional shortening (FS) were not different. Stress echocardiography was recorded with success in 90% of TM and 83% of N. During EX, FS increased progressively with increase of heart rate in both groups, though the increase of FS was lower in TM. Thus, asymptomatic young patients with thalassemia major, under well transfusion-chelation therapy, showed cardiac changes from volume overload. LV systolic function, normal at rest, was moderately impaired during exercise test.