1438
either
Cat: Pharmacologic stress testing - Echocardiography
CORRELATION BETWEEN CARDIOVASCULAR AND LIVER MAGNETIC
RESONANCE T2* AND TRANSTHORACIC ECHOCARDIOGRAPHIC STUDY
IN THALASSEMIA PATIENTS
M. Parsaee1, N. Akiash2, A. Azarkeivan3, Z. Ojaghi Haghighi1, M. Maleki4,
S.M.H. Adel2
1. Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran
University of Medical Sciences, Tehran, Iran
2. Atherosclerosis Research Center, Jundishapur University of Medical Sciences, Ahwaz, Iran
3. Transfusion Research center, High Institute for Research and Education in Transfusion
Medicine, Tehran, Iran
4. Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research
Center, Iran University of Medical Sciences, Tehran, Iran
Background and Objective: Heart failure is the most important reason of mortality and
morbidity in thalassemia patients. Repeated blood transfusions, peripheral hemolysis and
increased iron absorption from intestinal tissue in thalassemia patients resulting iron
overload and accumulation of iron in tissues such as myocardium. Early detection of
cardiac involvement is important to improvement of prognosis in these patients.
Transthoracic Echocardiography has been known as a non-invasive technique for routine
cardiac evaluation in thalassemia but left ventricular systolic function remains
approximately normal until late in thalassemia.
Method: 130 thalassemia patients (38.5% intermedia, 61.5% major) were selected, 8
patient were excluded due to poor image quality in echocardiographic study. T2*
cardiovascular and liver magnetic resonance was performed in the patients to assessment
of liver and myocardial iron load. 2D and 3D echocardiography and tissue Doppler study
were performed on all subjects.
Results: The mean value of LVEF in the thalassemia patients were 60% ± 0.6%. PAP was
higher in thalassemia intermedia than thalassemia major (P = 0.014) and PAP correlated
positively with age (P=0.003). There was a significant correlation between longitudinal
global strain and MRI T2* of the liver (P = 0.02) and cardiac (P = 0.006). There was
significant correlation between LVEF (by 3D method) and cardiac MRI T2*(P = 0.05).
Conclusions: Thalassemia patients with cardiac and liver iron overload had lower
longitudinal global strain and LVEF therefore in unequipped centers which CMR is not
available, evaluation of longitudinal global strain and LVEF with 3dimentional method
can be replacing tools.