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Cardiac iron overload detection using longitudinal strain in asymptomatic children with beta thalassemia major

Ikram Chamtouri1, Roueida Khalifa2, Habib Besbes3

  • 1Cardiology B Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia. ikram_chamtouri@hotmail.fr.

The International Journal of Cardiovascular Imaging
|November 26, 2022
PubMed

Insights

Iron overload in beta-thalassemia major (BTM) patients can cause heart problems. Longitudinal strain (LS) detected early subclinical myocardial dysfunction in children with BTM, even when standard echocardiograms appeared normal.

Area of Science:

  • Cardiology
  • Pediatrics
  • Medical Imaging

Background:

  • Iron disposition in cardiomyocytes is a major cause of morbidity and mortality in beta-thalassemia major (BTM) patients.
  • Conventional transthoracic echocardiography (TTE) parameters often remain normal in the early stages of iron overload cardiomyopathy.
  • Strain imaging, a myocardial deformation analysis, is crucial for early detection of cardiac iron overload.

Purpose of the Study:

  • To evaluate the utility of longitudinal strain (LS) in the early detection of cardiac iron overload in children with BTM.
  • To compare conventional TTE parameters and regional longitudinal strain (RLS) between BTM children and healthy controls.

Main Methods:

  • Sixty children (30 with BTM, 30 controls) underwent conventional TTE and LV regional longitudinal strain (RLS) analysis.
  • Demographic data, conventional TTE parameters, and RLS values were compared between the groups.

Main Results:

  • No significant difference in conventional TTE parameters was observed, except for a larger indexed left atrium (LA) area and volume in BTM children.
  • RLS was significantly reduced in the anterior, septal, and inferior walls (basal and middle segments) of the left ventricle in the BTM group compared to controls.
  • No significant difference in RLS was found in the apical segment between the groups.

Conclusions:

  • Longitudinal strain (LS) can detect subclinical myocardial dysfunction in asymptomatic BTM children with normal conventional TTE parameters.
  • Strain imaging offers a valuable tool for early diagnosis and monitoring of cardiac involvement in BTM.
  • Early detection through LS may enable timely intervention to prevent progression of iron overload cardiomyopathy.

Keywords:
Cooley’s anemiaDetectionInfantSpeckle tracking

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