Left and Right Atrial Function and Remodeling in Beta-Thalassaemia Major

Area of Science:

• Cardiology
• Hematology
• Echocardiography

Background:

• Beta-thalassaemia major is a genetic blood disorder requiring chronic transfusions.
• Cardiac complications, including iron overload, are significant concerns in these patients.
• Atrial function assessment is crucial for understanding the overall cardiovascular impact.

Purpose of the Study:

• To evaluate left atrial (LA) and right atrial (RA) function in patients with beta-thalassaemia major.
• To compare atrial strain and dimensions between patients and healthy controls.
• To investigate the relationship between myocardial iron overload and atrial remodeling.

Main Methods:

• Speckle-tracking echocardiography was used to quantify atrial and ventricular strain and strain rates.
• Two-dimensional planimetry measured maximum LA and RA areas.
• Thirty-eight beta-thalassaemia major patients and 43 controls were studied.

Main Results:

• Patients exhibited significantly reduced LA and RA peak positive strain, total strain, and LA strain rate.
• Significantly larger maximum LA and RA areas were observed in patients compared to controls.
• LV and RV strain/strain rates were similar; however, iron overload correlated with larger LA area.

Conclusions:

• Functional and structural remodeling of both atria occurs in beta-thalassaemia major.
• Atrial dysfunction is present even in the absence of ventricular diastolic dysfunction.
• These findings underscore the importance of monitoring atrial health in beta-thalassaemia major management.