Prevalence of left ventricular diastolic dysfunction by cardiac magnetic resonance imaging in thalassemia major

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Benjaporn Chinprateep1, Nithima Ratanasit1, Yodying Kaolawanich1

  • 1Division of Cardiology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand.

BMC Cardiovascular Disorders
|November 8, 2019
PubMed

Insights

Left ventricular diastolic dysfunction (LVDD) affects 20.7% of thalassemia major patients before cardiac iron overload is detected. Homozygous beta-thalassemia and splenectomy are key predictors, highlighting the need for early LVDD screening.

Area of Science:

  • Cardiology
  • Hematology
  • Medical Imaging

Background:

  • Iron overload cardiomyopathy is the primary cause of mortality in thalassemia major patients.
  • Early detection of left ventricular diastolic dysfunction (LVDD) before systolic dysfunction may improve patient prognosis.
  • This study investigates the prevalence and associated factors of LVDD in thalassemia major patients with preserved systolic function.

Purpose of the Study:

  • To determine the prevalence of LVDD in thalassemia major patients with normal left ventricular systolic function.
  • To identify factors associated with LVDD in this patient population.
  • To inform early diagnostic strategies and improve outcomes for thalassemia major patients.

Main Methods:

  • Cardiac magnetic resonance (CMR) imaging, specifically T2* sequences, was used to assess cardiac iron levels.
  • Left ventricular diastolic function was evaluated using mitral valve filling parameters and left atrial volume index.
  • Adult patients with thalassemia major and normal systolic function were included, excluding those with significant valvular or pericardial disease.

Main Results:

  • The prevalence of LVDD was 20.7% among the 116 included patients.
  • Cardiac T2* was abnormal in 7.8% of patients, indicating iron overload.
  • Multivariate analysis identified age, body surface area, homozygous beta-thalassemia, splenectomy, heart rate, and diastolic blood pressure as significant factors associated with LVDD.

Conclusions:

  • LVDD is present in early stages of thalassemia major, often preceding detectable cardiac iron overload (abnormal T2*).
  • Homozygous beta-thalassemia and splenectomy emerged as strong predictors of LVDD.
  • Findings emphasize the importance of increased awareness and early screening for LVDD in high-risk thalassemia major patient groups.
Abstract

Keywords:
Cardiac magnetic resonance imagingLeft ventricular diastolic dysfunctionThalassemia

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