Left ventricular systolic dyssynchrony index and endothelial dysfunction parameters as subclinical predictors of

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Hatice Solmaz1, Ali Kemal Cabuk1, Zeynep Altin2

  • 1Department of Cardiology, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey.

Echocardiography (Mount Kisco, N.Y.)
|May 4, 2021
PubMed

Insights

Three-dimensional echocardiography (3D-echo) parameters, specifically SDI12/16, show promise in predicting cardiovascular iron load in beta-thalassemia major (β-TM) patients. These findings aid in early detection of subclinical cardiac issues.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Hematology

Background:

  • Cardiovascular iron overload is a primary cause of mortality in beta-thalassemia major (β-TM).
  • Many β-TM patients remain asymptomatic despite significant cardiac involvement.
  • Early detection of cardiac iron load is crucial for managing β-TM.

Purpose of the Study:

  • To investigate the utility of 3D echocardiography and endothelial dysfunction parameters in asymptomatic β-TM patients.
  • To explore the relationship between these echocardiographic parameters and cardiac MRI T2* values.
  • To identify early indicators of subclinical cardiovascular involvement in β-TM.

Main Methods:

  • A cross-sectional study involving 51 asymptomatic β-TM patients receiving regular blood transfusions.
  • Patients were categorized based on cardiac MRI T2* values (<20 ms for high iron load, ≥20 ms).
  • Evaluation included 2D and 3D echocardiography, endothelial function tests (FMD, aortic strain), and ferritin levels.

Main Results:

  • 3D echocardiography parameters (LVEF-3D, SDI12, SDI16) and endothelial dysfunction markers (FMD, aortic strain) differed significantly between groups with high and low iron load.
  • SDI12 and SDI16 were negatively correlated with MRI T2* values.
  • Higher ferritin and SDI12/16 levels were independent predictors of myocardial iron load (MRI T2* <20 ms).
  • SDI16 > 5.5 and SDI12 > 4.3 demonstrated high sensitivity and specificity for detecting significant iron load.

Conclusions:

  • 3D echocardiography-derived SDI12/16 values are potential predictors of cardiovascular iron load in β-TM.
  • Decreased LVEF-3D, FMD, and aortic strain may indicate subclinical cardiac involvement in β-TM.
  • These non-invasive echocardiographic measures could facilitate early risk stratification and management in β-TM patients.
Abstract

Keywords:
3D-echocardiographybeta-thalassemia majorcardiovascular involvementendothelial dysfunction parametersleft ventricular systolic dyssynchrony index

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