Detection of Early Right Ventricular Dysfunction in Young Patients With Thalassemia Major Using Tissue Doppler Imaging|
Bornaun, Helen; Dedeoglu, Reyhan; Oztarhan, Kazim; Dedeoglu, Savas; Erfidan, Erkan; Gundogdu, Muge; Aydogan, Gonul & Cengiz, Dicle
Background: Myocardial iron overload is the mostcommoncause of mortality in patients with thalassemia major (TM), alsoknown
as beta-thalassemia. T2* cardiovascular magnetic resonance imaging (MRI) is the best way of monitoring cardiac iron, and new
echocardiographic techniques can be used to assess cardiac function.
Objectives: The aim of this study was to assess the systolic and diastolic right ventricular (RV) function of patients with TM using
tissue Doppler imaging (TDI) and to determine whether this echocardiographic technique is an adequate diagnostic tool for the
screening and detection of subclinical cardiac dysfunction.
Patients and Methods: Eighty-four patients with TM were evaluated by conventional echocardiography and pulse-wave TDI. The
data of the TM group (Group 1) were compared with that of 85 age- and sex-matched healthy controls (Group 2). Cardiovascular T2*
MRI examinations were performed in 49 of the 85 patients.
Results: The patients with TM had significantly lower values for weight, height, body mass index, systolic arterial pressure, deceleration
time, E’/A’, and ejection time (ET) than the controls. Group 1 also had significantly higher values for peak early diastolic
velocity (E) over peak late diastolic velocity (A), peak early diastolic velocity of TDI (E’), peak late diastolic velocity of TDI (A’), E/E’,
isovolumetric relaxation time, isovolumetric contraction time, and RV magnetic perfusion imaging (MPI) than Group 2.
Conclusions: RV diastolic dysfunction occurs before systolic deterioration in patients with TM and cannot be screened with conventional
echocardiographic techniques. In routine practice, TDI measurements, MPI (for global function) and the E/E’ parameter
(for diastolic function) can be used to screen and detect early RV dysfunction.
Beta-Thalassemia; Young Patients; Ventricular Function; Echocardiography