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Magnetic Resonance Derived Myocardial Strain Assessment Using Feature Tracking
Published on: February 12, 2011
Left atrial strain in patients with β-thalassemia major: a cross-sectional CMR study
Antonella Meloni1,2, Luca Saba3, Vincenzo Positano1,2
1Bioengineering Unit, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy.
Insights
Patients with beta-thalassemia major show impaired left atrial strain, a key indicator of cardiac issues. These findings highlight left atrial strain as a sensitive marker for cardiac complications in beta-thalassemia major.
Area of Science:
- Cardiology
- Hematology
- Medical Imaging
Background:
- Beta-thalassemia major (β-TM) is a genetic blood disorder requiring lifelong transfusions.
- Cardiac complications, including heart failure and arrhythmias, are a major cause of morbidity and mortality in β-TM patients.
- Left atrial (LA) function is increasingly recognized as a crucial indicator of cardiovascular health.
Purpose of the Study:
- To investigate the association of left atrial (LA) strain parameters with demographics, clinical data, cardiovascular magnetic resonance (CMR) findings, and cardiac complications in patients with β-TM.
- To compare LA strain in β-TM patients with healthy controls.
- To identify determinants of LA strain and its correlation with cardiac complications in β-TM.
Main Methods:
- A cross-sectional study involving 264 β-TM patients and 35 healthy controls.
- Cardiovascular magnetic resonance (CMR) feature tracking was used to analyze LA reservoir, conduit, and booster functions.
- Demographic, clinical, and CMR data, including late gadolinium enhancement (LGE), were collected.
Main Results:
- β-TM patients exhibited significantly lower LA reservoir strain, booster strains, and strain rates compared to controls.
- Ageing, sex, and left ventricular (LV) volume indexes were independent determinants of LA strain in β-TM patients.
- Reduced LA strain parameters were significantly associated with the number of LV segments with LGE and the presence of cardiac complications.
Conclusions:
- Left atrial strain parameters are impaired in patients with β-TM compared to healthy individuals.
- LA strain parameters are significantly correlated with LV myocardial scarring (LGE) and cardiac complications in β-TM.
- Impaired LA strain is a sensitive marker for cardiac complications in β-TM, potentially more so than cardiac iron levels.
Objectives:
The aim of this cross-sectional study was to investigate the association of left atrial (LA) strain parameters with demographics, clinical data, cardiovascular magnetic resonance (CMR) findings, and cardiac complications (heart failure and arrhythmias) in a cohort of patients with β-thalassemia major (β-TM).
Materials And Methods:
We considered 264 β-TM patients (133 females, 36.79 ± 11.95 years) consecutively enrolled in the Extension-Myocardial Iron Overload in Thalassemia (E-MIOT) project. Moreover, we included 35 sex- and age-matched healthy controls (14 females, mean age 37.36 ± 17.52 years). Reservoir, conduit, and booster LA functions were analysed by CMR feature tracking using dedicated software.
Results:
Compared to the healthy control group, β-TM patients demonstrated lower LA reservoir strain and booster strains, as well as LA reservoir and booster strain rates. However, no differences were found in LA conduit deformation parameters. In β-TM patients, ageing, sex, and left ventricle (LV) volume indexes were independent determinants of LA strain parameters. The number of segments with late gadolinium enhancement (LGE) significantly correlated with all LA strain parameters, with the exception of the LA conduit rate. Patients with cardiac complications exhibited significantly impaired strain parameters compared to patients without cardiac complications.
Conclusion:
In patients with β-TM, LA strain parameters were impaired compared to control subjects, and they exhibited a significant correlation with the number of LV segments with LGE. Furthermore, patients with cardiac complications had impaired left atrial strain parameters. Clinical relevance statement In patients with β-thalassemia major, left atrial strain parameters were impaired compared to control subjects and emerged as a sensitive marker of cardiac complications, stronger than cardiac iron levels.
Key Points:
• Compared to healthy subjects, β-thalassemia major patients demonstrated significantly lower left atrial reservoir strain and booster strains, as well as left atrial reservoir and booster strain rates. • In β-thalassemia major, ageing, sex, and left ventricular volume indexes were independent determinants of left atrial strain parameters, while left atrial strain parameters were not correlated with myocardial iron overload. • An independent association between reduced left atrial strain parameters and a history of cardiac complications was found in β-thalassemia major patients.
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