Background: β-thalassemia major is a unique disease characterized by early severe diastolic dysfunction, due to iron myocardial deposition alone, while left ventricular systolic dysfunction and failure seem to be multifactorial in aitiology.
Objectives: The purpose of this study was to investigate left ventricular diastolic dysfunction using a new echo index as speckle tracking in comparison with the conventional methods.
Material And Methods: Eighty-eight consecutive patients (38 male, 50 female) aged 36 ± 8.2 yr with β-thalassemia major and preserved LV ejection fraction (LVEF>55%) were studied. Patients were divided into two groups according to the E mitral/E mitral annulus ratio (E/E'): group A patients with E/E' ratio ≤8 and group B patients with E/E' >8. Cutoff value of eight was used to separate patients with normal and abnormal diastolic function. All subjects were studied thoroughly by tissue Doppler echocardiography as also by 2D left ventricular and atrial strain imaging 2-4 d following blood transfusion. Blood samples were also taken for plasma BNP measurements at the same time.
Results: Left atrial volumes(LAV max, LAV min) as also left atrial index were significantly higher in patients with diastolic dysfunction compared with patients without diastolic dysfunction(LAV max: 57.6 ± 19.4 vs. 71.3 ± 22.9, P < 0.01,LAV min: 20.2 ± 11.4 vs. 33.9 ± 18, P < 0.01, LAVI: 37.66 ± 12.18 vs. 47.13 ± 14.77, P < 0.01). Radial 2D strain (RS) and peak atrial 2D strain (AS) were significantly reduced in patients with suspected diastolic dysfunction compared with patients without diastolic dysfunction (RS: 43.48 ± 13.92 vs. 35.58 ± 11.32, P < 0.05; AS: 36.36 ± 8.45 vs. 29.85 ± 9.25, P < 0.01). Using ROC analysis, peak atrial 2D strain at a cutoff of 41.1 cm/s was highly accurate (AUC: 0.66, P < 0.05 in ruling out diastolic dysfunction (E/E'<8) with a sensitivity of 90% and a specificity of 81%.
Conclusions: B-thalassemic major patients with preserved left ventricular systolic function had impaired left atrial function at the longitudinal axis and left ventricular function at the radial axis. The new echo markers have better prognostic value than the traditional echo indexes in detecting latent diastolic dysfunction in β-thalassemia major, earlier than E/E' ratio.
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http://dx.doi.org/10.1111/ejh.12209 | DOI Listing |
Sci Rep
December 2024
Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
B-type natriuretic peptide (BNP) levels accurately reflect the degree of cardiac overload in heart failure. Considering cardiac morphology and intracardiac pressure, including the left ventricular end-systolic volume index (LVESVI) and left ventricular end-diastolic volume index (LVEDVI), is essential for cardiac overload assessment. These indexes influence plasma BNP levels, and high heart rate is likely associated with cardiac morphology.
View Article and Find Full Text PDFEur Heart J Case Rep
January 2025
Xijing Hypertrophic Cardiomyopathy Center, Department of Ultrasound, Xijing Hospital, Airforce Military Medical University, Xi'an, Shaanxi 710032, China.
Background: This is a case report of a patient with Fabry disease (FD). We successfully treated a patient with ventricular septal hypertrophy and left ventricular outflow tract (LVOT) obstruction caused by FD. We report our exclusive new surgery for patients with LVOT obstruction, percutaneous intramyocardial septal radiofrequency ablation (PIMSRA) procedure™ (percutaneous intramyocardial septal radiofrequency ablation).
View Article and Find Full Text PDFCureus
November 2024
Internal Medicine, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, IND.
Introduction The study aimed to retrospectively evaluate the early patient outcome and left ventricular function after mitral valve replacement with a tilting disc valve and total preservation. Patients and methods This retrospective observational study includes patients who underwent mitral valve replacement using a tilting disc valve with total preservation of mitral valvular and subvalvular apparatus from July 2021 to August 2022 at a single center. Results The data were reviewed retrospectively for age, sex, comorbidities, operating time, aortic cross-clamp time, cardiopulmonary bypass time, preoperative and postoperative left ventricular ejection fraction, mean gradient across the mitral valve, left ventricular diameter, left atrial size, atrial fibrillation, complications, mortality, and early patient outcome.
View Article and Find Full Text PDFCureus
November 2024
Cardiology, Mount Sinai West Hospital, New York, USA.
The mechanism and severity of mitral valve (MV) regurgitation (MR) play a critical role in guiding treatment decisions. Transthoracic echocardiography (TTE) is the primary diagnostic modality for evaluating MV disease. Discordant findings on TTE can be further quantified through transesophageal echocardiography (TEE).
View Article and Find Full Text PDFCureus
November 2024
Anesthesia and Critical Care, Mohammed VI University Hospital, Tangier, MAR.
Takotsubo cardiomyopathy (TTC), also known as stress-induced cardiomyopathy, is a rare condition in children that causes acute, severe, but often reversible systolic dysfunction of the left ventricle. Physical trauma is a recognized trigger, although distinguishing TTC from myocardial contusion in pediatric trauma cases can be challenging due to overlapping clinical features. We present the case of a six-year-old boy involved in a high-impact motor vehicle collision.
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