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Year : 2020  |  Volume : 33  |  Issue : 1  |  Page : 138-151

Left ventricular functions in patients with beta-thalassemia major: a speckle tracking imaging study

1 Department of Pediatrics, Faculty of Medicine, Menoufia University, Menoufia, Egypt
2 Department of Cardiovascular Medicine, Faculty of Medicine, Menoufia University, Menoufia, Egypt
3 Department of Pediatric, Benha Specialized Children Hospital, Benha, Egypt

Correspondence Address:
Amir I Lashin
Sabry Abo Alam Street, Shebin El-Kom, Menoufia Governorate
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mmj.mmj_639_16

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Objectives To assess left ventricular (LV) functions in patients with beta-thalassemia major (β-TM) on regular blood transfusion (without cardiac manifestations) by speckle tracking echocardiography and correlate the findings with serum ferritin levels of these patients. Background Patients with β-TM have extravasal hemolysis and ineffective erythropoiesis, resulting in severe anemia. Thus, they require regular blood transfusions, which results in iron overload. Patients with thalassemia absorb more iron than normal individuals. Iron overload results in iron deposition in a variety of parenchymal tissues including the heart leading to ventricular systolic and diastolic dysfunctions. Iron-mediated cardiomyopathy is the main cause of death in patients with thalassemia. Early detection of cardiac abnormalities is important as aggressive chelation therapy may improve prognosis in these patients. Patients and methods A total of 50 patients with β-TM on regular blood transfusion for more than or equal to 4 years and 25 sex-matched and age-matched controls were included. The laboratory parameters measured were blood hemoglobin and ferritin, which were measured 2 h before doing echocardiography with Doppler imaging and speckle tracking analysis. Results There were no significant differences in LV ejection fraction and fractional shortening between the groups by conventional echocardiography. However, by using speckle tracking echocardiography, systolic strain and strain rate of the LV walls were significantly lower in patients with thalassemia. Conclusion Patients with thalassemia have regional systolic dysfunction in the LV walls, even if they do not have overt heart failure. Strain imaging is more helpful than conventional echocardiography in early detection of LV systolic dysfunction in patients with thalassemia.

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