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The international journal of cardiovascular imaging
Feb, 2018;34 (2): 263-271.

Detection of myocardial iron overload by two-dimensional speckle tracking in patients with beta-thalassaemia major: a combined echocardiographic and T2* segmental CMR study.

Fausto Pizzino, Antonella Meloni, Anna Terrizzi, Tommaso Casini, Anna Spasiano, Carlo Cosmi, Massimo Allò, Concetta Zito, Scipione Carerj, Giovanni Donato Aquaro, Gianluca Di Bella, Alessia Pepe
Author Information
  1. Fausto Pizzino: Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, AOU "Policlinico G. Martino", Messina, Italy.
  2. Antonella Meloni: Magnetic Resonance Imaging Unit, Fondazione G. Monasterio CNR-Regione Toscana, Area della Ricerca S. Cataldo, Via Moruzzi, 1, 56124, Pisa, Italy.
  3. Anna Terrizzi: Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, AOU "Policlinico G. Martino", Messina, Italy.
  4. Tommaso Casini: Centro Talassemie ed Emoglobinopatie, Ospedale "Meyer", Firenze, Italy.
  5. Anna Spasiano: U.O.S.D. Centro per le Microcitemie, AORN Cardarelli, Napoli, Italy.
  6. Carlo Cosmi: Clinica Pediatrica, Azienda Ospedaliero-Universitaria di Sassari, Sassari, Italy.
  7. Massimo Allò: Servizio Microcitemia, Presidio Ospedaliero ASL 5, Crotone, Italy.
  8. Concetta Zito: Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, AOU "Policlinico G. Martino", Messina, Italy.
  9. Scipione Carerj: Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, AOU "Policlinico G. Martino", Messina, Italy.
  10. Giovanni Donato Aquaro: Magnetic Resonance Imaging Unit, Fondazione G. Monasterio CNR-Regione Toscana, Area della Ricerca S. Cataldo, Via Moruzzi, 1, 56124, Pisa, Italy.
  11. Gianluca Di Bella: Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, AOU "Policlinico G. Martino", Messina, Italy.
  12. Alessia Pepe: Magnetic Resonance Imaging Unit, Fondazione G. Monasterio CNR-Regione Toscana, Area della Ricerca S. Cataldo, Via Moruzzi, 1, 56124, Pisa, Italy. alessia.pepe@ftgm.it.
PMID: 28770456 DOI: 10.1007/s10554-017-1219-7

Abstract

We aimed to evaluate the role of two-dimensional speckle tracking imaging (2DSTI) in detecting early changes of myocardial deformation in patients affected by thalassemia major (TM) and its relation with myocardial iron overload (MIO) detected by T2* cardiovascular magnetic resonance (CMR). We studied 28 TM patients (15 males, 37.4 ± 10 years). All patients underwent CMR and echocardiography in the same day. Segmental and global T2* values were measured. Values of global longitudinal strain (GLS) were derived from the three apical views, while radial and circumferential strain were obtained as average strain from the short axis views at basal, mid and apical level. Six patients (21.4%) showed significant MIO (global heart T2* < 20 ms). GLS showed a significant correlation with T2* values (R = -0.49; P = 0.001) and it was significantly lower in patients with a significant MIO than in those with no significant MIO (-18.3 ± 2 vs. -21.3 ± 2.7, P = 0.02). No significant difference was found for radial and circumferential strain in relation to the severity of MIO. Patients with impaired GLS (<-19.5%) had a significant higher risk of showing significant MIO (Odds-ratio-OR = 17; 95%). GLS is related with global T2* in TM patients. Moreover, GLS can identify TM patients with severe MIO detected by CMR.

Keywords

Myocardial deformation Myocardial iron overload Thalassemia major

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MeSH Term

Adult
Area Under Curve
Biomechanical Phenomena
Cardiomyopathies
Chi-Square Distribution
Early Diagnosis
Echocardiography, Doppler
Female
Humans
Iron
Iron Overload
Logistic Models
Magnetic Resonance Imaging, Cine
Male
Middle Aged
Multimodal Imaging
Myocardial Contraction
Myocardium
Observer Variation
Odds Ratio
Predictive Value of Tests
ROC Curve
Reproducibility of Results
Risk Factors
Severity of Illness Index
beta-Thalassemia

Chemicals

Iron
Evaluation Study Journal Article
Article has an altmetric score of 1

Word Cloud

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