Original Article

Evaluation of diagnostic power of Tissue Doppler Echocardiography for assessment of cardiac iron overload in patients with thalassemia major

Abstract


Background and Aim: Iron overload in patients with thalassemia major is one of the most important complications of this disease and its cardiac complications are the most important causes of death in these patients.MRI T2 is the perfect device to assess the amount of iron deposited in the heart of thalassemia patients, but it causes waste of time and also is an expensive diagnostic method. Tissue Doppler echocardiography is the newer method for this evaluation.Herein, this study was conducted to determine efficacy and specificity of tissue Doppler echocardiography in the assessment of heart iron overload in patients with thalassemia major.
Materials & Methods: It was a diagnostic power assessment research?? performed on 50 patients with thalassemia major aged ≥ 15 years old that had been visited in BoualiSina Hospital in sari, Iran. After the study was explained and patients agreed to participate, written informed consent was obtained. All the patients underwent MRI T2* and tissue Doppler echocardiography results were obtained. The collected data were processed with SPSS 16 and specificity and efficacy of tissue Doppler echocardiography were obtained. In all analysis, P value< 0.05 was considered statistically significant.
Result: Patients were divided into four groups: normal amount of iron in the heart tissue, mild, moderate and severe. There was a good compatibility between results of MRI T2* and tissue Doppler echocardiography.
Conclusion: we can offer that tissue Doppler echocardiography is a worthy method for evaluating cardiac complications of iron overload in patients with thalassemia major.

Borgna Pignatti C, Galanello R. Thalassemias and related disorders: Quantities disorders of hemoylobin synthesis. Greer Jp, Foerster J, Rodgers GM, Paraskevas F, Glader B, Arber DA, et al(eds). Wintrobe's Clinical Hematology. 20th ed. Philadelphia: Lippincott Wiliams. 1083 – 1131.2008.

Debaun MR, Jones MF, etal .Hemoglobinopathies. In: kliegman RM, Stanton BF, GemeJSt, Schor N, Behrman Re. Nelson Textbook of Pediatrics. 19thed .Philadelphia : Saunders ; 2011 , P: 1674 – 1677.

Kremastinos DT, Tiniakos G, Theodorakis GN, Katritsis DG, Toutouzas PK. Myocarditis in beta-thalassemia major.A cause of heart failure.Circulation. 1; 91(1):66-71. 1995

BosiG, CrepazR, Gamberini MR, Fortini M, Scarcia S, Bonsante E, et al. Leftventricularremodelling, and systolic and diastolicfunction in youngadults with betathalassaemia major: a Doppler echocardiographic assessment and correlation with haematologicaldata. Heart.89(7):762-6.2003.

Vogel M, Anderson LJ, Holden S, Deanfield JE, Pennell DJ, Walker JM. Tissue Doppler echocardiography in patients with thalassaemia detects early myocardial dysfunction related to myocardial iron overload. Eur Heart J. 24(1):113-9. 2003.

Leonardi B, Margossian R, Colan SD, Powell AJ. Relationship of magnetic resonance imaging estimation of myocardial iron to left ventricular systolic and diastolic function in thalassemia. JACC Cardiovasc Imaging. 1(5):572-8. 2008.

Marcí M, Pitrolo L, Lo Pinto C, Sanfilippo N, Malizia R. Detection of early cardiac dysfunction in patients with Beta thalassemia by tissue Doppler echocardiography.Echocardiography.28(2):175-80. 2011.

Hamdy AM. Use of strain and tissue velocity imaging for early detection of regional myocardial dysfunction in patients with beta thalassemia.Eur J Echocardiogr. 8(2):102-9. 2007.

Garadah TS, kassab S, Mahdi M, Abu-Taleb A, Jamsheer A. Pulsed and Tissue Doppler Echocardiographic Changes in Patients with Thalassemia Major. Clinical Medicine Insights: Blood Disorders. 3: 1-8. 2012.

Aggeli C, Felekos I, Poulidakis E, Aggelis A, Tousoulis D, Stefanadis C. Quantitative analysis of left atrial function in asymptomatic patients with b-thalassemia major using real-time three-dimensional echocardiography.Cardiovasc Ultrasound. 24;9:38. 2011

Gujja P, Rosing DR, Tripodi DJ, Shizukuda Y. Iron overload cardiomyopathy: better understanding of an increasing disorder. J Am CollCardiol. 21; 56(13):1001-12. 2010

Files
IssueVol 6, No 4 (2012) QRcode
SectionOriginal Article(s)
Keywords
Diagnostic power Tissue Doppler Echocardiography Cardiac Iron Overload Thalassemia major
Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Dabirian M, Jalalian R, Karami H, Kowsarian M, Ahmadi A, Shokohi L, Alizadeh Navaei R. Evaluation of diagnostic power of Tissue Doppler Echocardiography for assessment of cardiac iron overload in patients with thalassemia major. Int J Hematol Oncol Stem Cell Res. 2015;6(4):14-19.