Author:
Bonios Michael J.,Fountas Epameinontas,Delaporta Polyxeni,Kyrzopoulos Stamatis,Kattamis Antonis,Adamopoulos Stamatis N.,Tsiapras Dimitris
Abstract
Abstract
Background
Myocardial iron overload in patients with thalassemia major (TM) is one of the most important complications. The purpose of the study was to identify advanced echocardiography parameters for early identification of myocardial dysfunction during follow-up of patients with TM.
Methods
Forty TM patients who were 41 ± 5 years old were included in the study and divided into two groups according to cardiac magnetic resonance T2* results (Group 1: Τ2* > 25 ms, Group 2: Τ2* ≤ 25 ms). Liver T2* parameters were also measured. Conventional and deformational echocardiographic parameters were measured at baseline and approximately 2 years later.
Results
Thirty-two patients had Τ2* = 34 ± 4 ms (Group 1), and 8 had Τ2* = 17 ± 9 ms (Group 2). Blood consumption was 185 ± 60 and 199 ± 37 ml/kg/yr (p = 0.64), and liver T2* was 4 ± 5 and 17 ± 21 ms (p = 0.01) in Groups 1 and 2, respectively. At baseline, Group 1 had better left ventricular global longitudinal strain (GLS) (− 22 ± 3 vs. − 18 ± 5, p = 0.01) and similar left ventricular ejection fraction (LVEF) (62 ± 5% vs. 58 ± 10%, p = 0.086) than Group 2. At the 28 ± 11-month follow-up, LVEF, GLS, and T2* values in Group 1 (63 ± 3%, − 21 ± 3%, 34 ± 4 ms) and Group 2 (56 ± 11%, − 17 ± 4%, 17 ± 9 ms) did not change significantly compared to their corresponding baseline values. In 8 patients from Group 1, a worsening (> 15%) in LS (p = 0.001) was detected during follow-up, with a marginal reduction in LVEF.
Conclusions
GLS seems to be an efficient echocardiographic parameter for detecting hemochromatosis-related cardiac dysfunction earlier than LVEF. It also seems to be affected by other factors (free radical oxygen, immunogenetic mechanisms or viral infections) in a minority of patients, underscoring the multifactorial etiology of cardiomyopathy.
Publisher
Springer Science and Business Media LLC
Subject
Cardiology and Cardiovascular Medicine
Reference37 articles.
1. Borgna-Pignatti C, Cappellini MD, De Stefano P, Del Vecchio GC, Forni GL, Gamberini MR, Ghilardi R, Origa R, Piga A, Romeo MA, et al. Survival and complications in thalassemia. Ann N Y Acad Sci. 2005;1054:40–7.
2. Kremastinos DT, Farmakis D, Aessopos A, Hahalis G, Hamodraka E, Tsiapras D, Keren A. Beta-thalassemia cardiomyopathy: history, present considerations, and future perspectives. Circulation. 2010;3(3):451–8.
3. Rund D, Rachmilewitz E. Beta-thalassemia. N Engl J Med. 2005;353(11):1135–46.
4. Pradhan V, Badakere S, Ghosh K. Antihistone and other autoantibodies in beta-thalassemia major patients receiving iron chelators. Acta Haematol. 2003;109(1):35–9.
5. Barbero U, Fornari F, Guarguagli S, Gaglioti CM, Longo F, Doronzo B, Anselmino M, Piga A. Atrial fibrillation in beta-thalassemia Major Patients: Diagnosis, Management and Therapeutic Options. Hemoglobin. 2018;42(3):189–93.
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