Left Ventricular Regional Function in Children with Beta Thalassemia with No Cardiac Manifestations (Four-Dimensional Echocardiographic Study)

• Published in: Indian journal of hematology & blood transfusion 2019-10, Vol.35 (4), p.750-757
• Main Authors: El Razaky, Osama Abdrabelrasool, El-Shanshory, Mohamed Ramadan, El-Shehaby, Waleed Ahmed, Hables, Nahed Mohamed, Elshamia, Adel Mohamed, Fayed, Ahmed Mohamed, El-Kholy, Ahmed Elsayed, El-Dosoky, Esraa Ahmed
• Format: Article
• Language: English
• Subjects: Blood diseases; Blood Transfusion Medicine; Cardiovascular disease; Ejection fraction; Hematology; Human Genetics; Medicine; Medicine & Public Health; Oncology; Original; Original Article; Pediatrics; Ultrasonic imaging
• ISSN: 0971-4502; 0974-0449; 0974-0449; 0971-4502
• DOI: 10.1007/s12288-019-01117-6

Early detection of myocardial dysfunction is essential for the management of patients with thalassemia. Four-dimensional echocardiography imaging technique may be useful for detecting subclinical cardiovascular disease. To evaluate the 4-dimensional echocardiographic strain in children with beta thalassemia major with no cardiac manifestation and correlate it with other echocardiographic parameters. This is a prospective cross-sectional cohort Study included 200 children, 1–18 years-old. They were divided into: One hundred children with p-Thalassemia major with no clinical cardiac manifestations and 100 healthy children as a control group. They were subjected to the following investigations: Complete blood count, serum ferritin and Four-dimensional echocardiographic strains (Longitudinal, Circumferential, Radial and Area strains). There was no significant difference between the two groups as regard mitral annulus systolic velocity (S wave), E/A ratio and iso-volumic acceleration, but there was a significant difference as regard to ejection fraction, left ventricle mass, sphericity index and myocardial performance index. The mean values of Left Ventricular Strains (Longitudinal, Circumferential, Radial and Area strains) were significantly lower in patients with thalassemia (− 14.86 ± 12.13, − 8.01 ± 3.829, 33.13 ± 10.61, − 19.45 ± 6.866) than controls (− 19.13 ± 1.502, − 16.32 ± 1.34, 37.28 ± 4.209, − 22.94 ± 3.06) than controls respectively with a positive correlation with 2-Dimensional strain. Strain parameters of the left ventricle obtained by four-dimensional.