Müfide OKAY, Cem COTELİ, Şule UNAL, Tuncay HAZIROLAN, Erdem KARABULUT, Necla ÖZER, Fatma GÜMRÜK, Nilgun SAYINALP

Strain Imaging by Speckle Tracking for the Assessment of Diastolic Dysfunction in Beta-Thalassemia Major Patients

Objectives: Strain imaging is a novel promising echocardiographic technique and strain imaging by speckle tracking has been reported recently in a few studies as a promising tool to detect early changes of myocardial deformation that could be related to myocardial iron over load in patients with β-thalassemia major. In this study, we investigated strain images in comparison with the cardiac T2* magnetic resonance imaging results. Materials and Methods: A total of 45 patients from a single institution’s pediatric and adult hematology centers were evaluated with strain echocardiography and T2* magnetic resonance imaging at concomitant out-patient visits. We grouped patients according to cardiac T2* magnetic resonance imaging results:

PDF

___

[1]Aydinok Y. Thalassemia. Hematology 2012; 17 Suppl 1: S28-31.

[2]Aydinok Y, Porter JB, Piga A, et al. Prevalence and distribution of iron overload in patients with transfusion-dependent anemias differs across geographic regions: results from the CORDELIA study. Eur J Haematol 2015;95(3): 244-53.

[3]Hoffbrand AV, Taher A, Cappellini MD. How I treat transfusional iron overload. Blood 2012;120(18): 3657-69.

[4]Gorcsan J, Tanaka H. Echocardiographic assessment of myocardial strain. Journal of the American College of Cardiology 2011; 58(14): 1401-13.

[5]Carpenter JP, Roughton M, Pennell DJ. International survey of T2* cardiovascular magnetic resonance in beta-thalassemia major. Haematologica 2013; 98(9): 1368-74.

[6]Meloni A, De Marchi D, Positano V, et al. Accurate estimate of pancreatic T2* values: how to deal with fat infiltration. Abdominal Imaging 2015; 40(8): 3129-36.

[7]Aydinok Y, Oymak Y, Atabay B, et al. A National Registry of Thalassemia in Turkey: Demographic and Disease Characteristics of Patients, Achievements, and Challenges in Prevention. Turk J Haematol 2018;35(1): 12-8.

[8]Kremastinos DT, Tsiapras DP, Tsetsos GA, et al. Left ventricular diastolic Doppler characteristics in beta-thalassemia major. Circulation 1993;88(3): 1127-35.

[9]Kostopoulou AG, Tsiapras DP, Chaidaroglou AS, et al. The pathophysiological relationship and clinical significance of left atrial function and left ventricular diastolic dysfunction in beta-thalassemia major. Am J Hematol 2014; 89(1): 13-8.

[10]Gorcsan J, 3rd, Tanaka H. Echocardiographic assessment of myocardial strain. Journal of the American College of Cardiology 2011; 58(14): 1401-13.

[11]Collier P, Phelan D, Klein A. A Test in Context: Myocardial Strain Measured by Speckle-Tracking Echocardiography. Journal of the American College of Cardiology 2017; 69(8): 1043-56.

[12]Gupta A, Kapoor A, Phadke S, et al. Use of strain, strain rate, tissue velocity imaging, and endothelial function for early detection of cardiovascular involvement in patients with beta-thalassemia. Annals of pediatric cardiology 2017;10(2): 158-66.

[13]Galderisi M, Cosyns B, Edvardsen T, et al. Standardization of adult transthoracic echocardiography reporting in agreement with recent chamber quantification, diastolic function, and heart valve disease recommendations: an expert consensus document of the European Association of Cardiovascular Imaging. European heart journal cardiovascular Imaging 2017;18(12): 1301-10.

[14]Kremastinos D, Toutouzas P, Vyssoulis G, Venetis C, Avgoustakis D. Iron overload and left ventricular performance in beta thalassemia. Acta cardiologica 1984;39(1): 29-40.

[15]Garceau P, Nguyen ET, Carasso S, et al. Quantification of myocardial iron deposition by two-dimensional speckle tracking in patients with beta-thalassaemia major and Blackfan-Diamond anaemia. Heart 2011; 97(5): 388-93.

[16]Karamanou AG, Hamodraka ES, Vrakas SC, et al. Assessment of left ventricular and atrial diastolic function using two-dimensional (2D) strain imaging in patients with beta-thalassemia major. Eur J Haematol 2014; 92(1): 59-65.

[17]Parsaee M, Akiash N, Azarkeivan A, et al. The correlation between cardiac magnetic resonance T2* and left ventricular global longitudinal strain in people with beta-thalassemia. Echocardiography 2018; 35(4): 438-44.

[18]Pizzino F, Meloni A, Terrizzi A, et al. Detection of myocardial iron overload by two-dimensional speckle tracking in patients with beta-thalassaemia major: a combined echocardiographic and T2* segmental CMR study. The International Journal of Cardiovascular Imaging 2018; 34(2): 263-71.