Assessment of left ventricular and atrial diastolic function using two‐dimensional (2<scp>D</scp>) strain imaging in patients with β‐thalassemia major

Karamanou, A.; Hamodraka, E.; Vrakas, Spyridon; Paraskevaidis, Ioannis; Lekakis, Ioannis; Kremastinos, Dimitrios Th.

doi:10.1111/ejh.12209

Cited by 19 publications

(10 citation statements)

References 34 publications

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“…Also for quantification of segmental and global circumferential myocardial deformation, from the short‐axis view, the left ventricle was divided into six segments (mid‐anteroseptum, mid‐anterior, mid‐anterolateral, mid‐inferolateral, mid‐inferior, and mid‐inferoseptum). Based on the entire short‐axis contour at papillary muscle level, we made the calculations on these six segments …”

Section: Methodsmentioning

confidence: 99%

Assessment of left ventricular functions and myocardial iron load with tissue Doppler and speckle tracking echocardiography and T2* MRI in patients with β‐thalassemia major

et al. 2017

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Section: Methodsmentioning

confidence: 99%

Assessment of left ventricular functions and myocardial iron load with tissue Doppler and speckle tracking echocardiography and T2* MRI in patients with β‐thalassemia major

et al. 2017

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“…Different studies have shown an early compromise of diastolic function in young patients with beta thalassemia and marked Fe overload (ferritin > 2000 ng/mL). Kostopoulo et al observed an increase in LA size and a decrease in the active and passive ejection fraction of the left atrium compared with a control population (19), and in the same sense, a decrease in atrial strain has been observed during the reservoir phase (20). The compromise of the LA function could occur both as a consequence of the increase in its afterload due to the increased LV rigidity, as well as its intrinsic compromise by Fe deposits in the atrial myocardium.…”

Section: Discussionmentioning

confidence: 94%

Analysis of the left atrial function using two dimensional strain in patients with recent diagnosis of hereditary hemochromatosis

Saad

Aladio

Yamasato

et al. 2021

European Heart Journal - Cardiovascular Imaging

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Funding Acknowledgements Type of funding sources: None. Background. Hereditary hemochromatosis (HH) is a genetic condition associated with a systemic iron overload caused by a reduction in the concentration of the iron regulatory hormone hepcidin or the hepcidin-ferroportin complex activity. Heart failure is the leading cause of death. It has been demonstrated early stages of systolic and diastolic left ventricular dysfunction in previous studies. The main function of the left atrium (LA) is to modulate the left ventricular filling through the reservoir, conduct and bump phases. Purpose. To compare the LA function between asymptomatic and recently diagnosed HH patients and a control group using two-dimensional speckle tracking. Methods. In this prospective study, 30 patients with HH (90% males, 47 ± 18 years old) and 30 healthy controls with a normal echo stress test (85% males, 45 ± 13 years old) were included. A conventional echocardiogram was performed. LA strain, LA strain rate and LA volumetric parameters during the reservoir, conduit and bump phases were studied according to the current recommendations. The LA stiffness index was calculated by using the ratio between E/e´ ratio and LA strain during the reservoir phase. Results. LA volume was similar in both groups (36,5 ± 10 ml vs 32,3 ± 6,5 ml; p = 0.09). No differences were observed in LA ejection fraction (EF) (57.5 ± 10% vs 60 ± 5%; p = 0.32), LA passive EF (35 ± 12% vs 36 ± 9%; p = 0.82) or LA bump function (34 ± 11% vs 36 ± 9.9%; p = 0.41) between both groups. On the contrary, the HH group had lower LA reservoir strain (31.5 ± 6.5% vs 38.3 ± 7.9%; p = 0.002) and during the conduct phase (18 ± 7% vs 23.3 ± 6.4%; p = 0.01) than the control group. The LA stiffness index was significantly higher in the HH group (25.5 ± 9.1 vs 19.5 ± 6.4; p = 0.01). Conclusion. Early abnormalities in the LA function could be detected by using two-dimensional speckle tracking study despite no evidence of changes in atrial size or volumetric parameters. Abstract Figure.

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“…These methods have already been evaluated specifically in patients with β-thalassemia, demonstrating an important correlation even with cardiac damage secondary to iron overload 14 . They also present a better prognostic value for diastolic dysfunction in this group of patients than parameters evaluated in traditional echocardiography 15 . The use of these new techniques in heterozygous patients still needs to be evaluated in future studies.…”

Section: Discussionmentioning

confidence: 99%

Echocardiografic abnormalities in patients with sickle cell/β-thalassemia do not depend on the β-thalassemia phenotype

Benites

Cisneiros

Bastos

et al. 2019

Hematology, Transfusion and Cell Therapy

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Objectives and methods We evaluated possible relationships between echocardiographic findings and clinical and laboratory parameters, in a cohort of Brazilian patients diagnosed with sickle cell/β-thalassemia, to better understand the cardiac involvement in this disease. Results Left atrial (LA) and left ventricular (LV) dilation were found in 19.5 and 11% of patients, respectively; systolic left ventricular dysfunction was present in a single patient. There were no differences in masses and volumes of cardiac chambers comparing Sβ 0 with Sβ + patients, and no relationship between these parameters and specific complications of the disease. However, parameters of altered ventricular geometry were significantly correlated with serum creatinine, hepatic transaminases and bilirubin levels. Moreover, 3 patients presented stroke; they were significantly older [53 (41–56) × 37.5 (18–70), p = 0.048], had higher values of LV posterior wall diastolic thickness [10 (10–11) × 8 (6–14), p = 0.03], LV mass [226 (194–260) × 147 (69–537), p = 0.039] and LA/aortic ratio [1.545 (1.48–1.61) × 1.26 (0.9–1.48), p = 0.032]. Conclusions Cardiac involvement in this disease does not appear to depend on the thalassemia phenotype. The presence of signs of myocardial remodeling in this group of patients was related to multi-organ impairment and rendered a higher propensity for stroke in older patients, suggesting the need for greater vigilance and control of associated factors.

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Assessment of left ventricular and atrial diastolic function using two‐dimensional (2D) strain imaging in patients with β‐thalassemia major

Cited by 19 publications

References 34 publications

Assessment of left ventricular functions and myocardial iron load with tissue Doppler and speckle tracking echocardiography and T2* MRI in patients with β‐thalassemia major

Assessment of left ventricular functions and myocardial iron load with tissue Doppler and speckle tracking echocardiography and T2* MRI in patients with β‐thalassemia major

Analysis of the left atrial function using two dimensional strain in patients with recent diagnosis of hereditary hemochromatosis

Echocardiografic abnormalities in patients with sickle cell/β-thalassemia do not depend on the β-thalassemia phenotype

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