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Left Ventricular Regional Function in Children with Beta Thalassemia with No Cardiac Manifestations (Four-Dimensional
Osama Abdrabelrasool El Razaky1, Mohamed Ramadan El-Shanshory1, Waleed Ahmed El-Shehaby1
11Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta, Egypt.
Insights
Four-dimensional echocardiography reveals reduced left ventricular strain in children with beta-thalassemia major, even without cardiac symptoms. This technique aids in early detection of subclinical cardiovascular disease in these patients.
Area of Science:
- Cardiology
- Pediatrics
- Hematology
Background:
- Early detection of myocardial dysfunction is crucial for managing patients with thalassemia.
- Four-dimensional echocardiography (4DE) shows promise in identifying subclinical cardiovascular disease.
Purpose of the Study:
- To evaluate 4DE-derived strain parameters in children with beta-thalassemia major who have no cardiac manifestations.
- To correlate these strain parameters with other echocardiographic measures.
Main Methods:
- A prospective cross-sectional cohort study included 200 children (1-18 years): 100 with beta-thalassemia major and 100 healthy controls.
- Investigations included complete blood count, serum ferritin, and 4DE-derived strain analysis (Longitudinal, Circumferential, Radial, and Area strains).
Main Results:
- While mitral annulus systolic velocity (S wave), E/A ratio, and iso-volumic acceleration showed no significant difference, ejection fraction, left ventricle mass, sphericity index, and myocardial performance index differed significantly between groups.
- Mean Left Ventricular Strains (Longitudinal, Circumferential, Radial, Area) were significantly lower in thalassemia patients compared to controls.
- A positive correlation was observed between 4DE strain parameters and 2-Dimensional strain.
Conclusions:
- Four-dimensional echocardiographic strain parameters are significantly reduced in children with beta-thalassemia major, even in the absence of clinical cardiac manifestations.
- 4DE is a valuable tool for detecting subclinical myocardial dysfunction in pediatric patients with thalassemia.
Abstract:
Early detection of myocardial dysfunction is essential for the management of patients with thalassemia. Four-dimensional echocardiography imaging technique may be useful for detecting subclinical cardiovascular disease. To evaluate the 4-dimensional echocardiographic strain in children with beta thalassemia major with no cardiac manifestation and correlate it with other echocardiographic parameters. This is a prospective cross-sectional cohort Study included 200 children, 1-18 years-old. They were divided into: One hundred children with p-Thalassemia major with no clinical cardiac manifestations and 100 healthy children as a control group. They were subjected to the following investigations: Complete blood count, serum ferritin and Four-dimensional echocardiographic strains (Longitudinal, Circumferential, Radial and Area strains). There was no significant difference between the two groups as regard mitral annulus systolic velocity (S wave), E/A ratio and iso-volumic acceleration, but there was a significant difference as regard to ejection fraction, left ventricle mass, sphericity index and myocardial performance index. The mean values of Left Ventricular Strains (Longitudinal, Circumferential, Radial and Area strains) were significantly lower in patients with thalassemia (- 14.86 ± 12.13, - 8.01 ± 3.829, 33.13 ± 10.61, - 19.45 ± 6.866) than controls (- 19.13 ± 1.502, - 16.32 ± 1.34, 37.28 ± 4.209, - 22.94 ± 3.06) than controls respectively with a positive correlation with 2-Dimensional strain. Strain parameters of the left ventricle obtained by four-dimensional.
