Determination Of Cardiac Dysfunction By T2 * MRI and Tissue Doppler
Echocardiography in Patıents With Thalassemia Major
Abstract
Background: Tissue Doppler (TD) measurements give a better information
in evaluating the myocardial functions than conventional
echocardiography in beta-thalassemia major (β-TM). The aim of this study
was to determine cardiac status of thalassemia patients by using both
T2*MRI and TD. Methods: The study group included thalassemia patients
(n=33) with normal systolic functions defined by conventional
echocardiography. The control group (n=37) consisted of age and sex
matched healthy individuals. TD measurements from three different
regions of myocardium were obtained in both groups. Ferritin was
examined in both groups, T2*MRI was performed only patients with
thalassemia. Results: Systolic and diastolic functions were found normal
by conventional echocardiography in thalassemia patients. However,
cardiac functions were significantly impaired when evaluated by TD
(p<0.05). T2*MRI and TD measurements didn’t differ according
to serum ferritin levels (p>0.05). Twenty-one patients
(63.6%) had myocardial iron overload. Both isovolumetric acceleration
time of left ventricle and myocardial performance index (MPI-septal)
were found significantly impaired in these patients (p<0.05).
There was negative correlation between MPI-septal and T2*MRI
measurements in thalassemia patients (r:-0.343, p=0.050). TD
measurements obtained from septum were found similar with the control
(p>0.05) but, the same measurements from left and right
ventricular walls were significantly impaired in iron unloaded group
(p< 0.05). Coclusion: Iron unloaded patients according to
T2*MRI had left and right ventricular dysfunction determined by TD.
Therefore, we suggest that combining T2*MRI with TD measurements, for
evaluating cardiac status in β-TM, in whose with normal T2*MRI scores,
would be better management of cardiac complications.