Left and right atrioventricular coupling index in patients with beta-thalassemia major

Area of Science:

• Cardiology
• Hematology
• Medical Imaging

Background:

• Beta-thalassemia major (β-TM) is a genetic blood disorder requiring lifelong transfusions, leading to iron overload and cardiac complications.
• Assessing cardiac function and identifying at-risk patients are crucial for managing β-TM.
• Atrioventricular coupling indices (LACI and RACI) may offer insights into cardiac health in β-TM.

Purpose of the Study:

• To investigate the relationship between left and right atrioventricular coupling indices (LACI and RACI) and clinical factors, cardiac magnetic resonance findings, and complications in β-TM patients.
• To determine if LACI and RACI are associated with myocardial iron overload or cardiac complications like heart failure, arrhythmias, and pulmonary hypertension.

Main Methods:

• A cross-sectional study involving 292 β-TM patients and 32 healthy controls.
• Measurement of left and right atrioventricular coupling indices (LACI and RACI) using cardiac magnetic resonance imaging.
• Analysis of demographic data, clinical information, late gadolinium enhancement (LGE), and cardiac complications.

Main Results:

• β-TM patients exhibited significantly higher LACI and RACI compared to controls.
• Aging, diabetes, splenectomy, and the presence of LGE were positively associated with both LACI and RACI.
• Late gadolinium enhancement (LGE) was an independent predictor of impaired LACI and RACI.
• LACI and RACI were not correlated with myocardial iron overload but were significantly higher in patients with cardiac complications.

Conclusions:

• LACI and RACI are elevated in β-TM patients and are associated with clinical factors and cardiac magnetic resonance findings, particularly LGE.
• Impaired LACI and RACI are linked to the presence of cardiac complications in β-TM.
• These indices may serve as potential biomarkers for cardiac risk stratification in β-TM.