Abstract
Traditional echocardiography is unable to detect neither the early stages of iron overload cardiomyopathy nor myocardial iron deposition. The aim of the study is to determine myocardial systolic strain indices in thalassemia major (TM), and assess their relationship with T2*, a cardiac magnetic resonance index of the severity of cardiac iron overload. 55 TM cases with recent cardiac magnetic resonance (CMR-T2*) underwent speckle tracking analysis to assess regional myocardial strains and rotation. The results were compared with a normal control group (n = 20), and were subsequently analyzed on the basis of the CMR-T2* values. Two TM groups were studied: TM with significant cardiac iron overload (“low” T2*, ≤20 ms; n = 21), and TM with normal T2* values (“normal” T2*, >20 ms; n = 34). TM patients show significant, uniform decrease in circumferential and radial strain (P < 0.05), and a remarkable reduction in end-systolic rotation, both global, and for all segments (P < 0.001). No significant differences were found between the low- and the normal T2* group either in regional strains and rotation or in standard echocardiographic and CMR parameters. Spearman’s correlation coefficient shows no significant correlation between myocardial strains, rotation and cardiac T2* values. In conclusion, our results are in accordance with recent evidence that myocardial iron overload is not the only mechanism underlying iron cardiomyopathy in TM. Strain imaging can predict subclinical myocardial dysfunction irrespective of CMR-T2* values, although it cannot replace CMR-T2* in assessing cardiac iron overload. Finally, it might be useful to appropriately time cardioactive treatment.
| Original language | English |
|---|---|
| Pages (from-to) | 799-809 |
| Number of pages | 11 |
| Journal | Internal and Emergency Medicine |
| Volume | 12 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - Sep 1 2017 |
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Keywords
- Beta-thalassemia major
- Cardiac magnetic resonance T2*
- Iron overload cardiomyopathy
- Strain imaging
ASJC Scopus subject areas
- Internal Medicine
- Emergency Medicine
Cite this
Myocardial deformation in iron overload cardiomyopathy : speckle tracking imaging in a beta-thalassemia major population. / Di Odoardo, Luca Antonio Felice; Giuditta, Marianna; Cassinerio, Elena; Roghi, Alberto; Pedrotti, Patrizia; Vicenzi, Marco; Sciumbata, Veronica Maria; Cappellini, Maria Domenica; Pierini, Alberto.
In: Internal and Emergency Medicine, Vol. 12, No. 6, 01.09.2017, p. 799-809.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Myocardial deformation in iron overload cardiomyopathy
T2 - speckle tracking imaging in a beta-thalassemia major population
AU - Di Odoardo, Luca Antonio Felice
AU - Giuditta, Marianna
AU - Cassinerio, Elena
AU - Roghi, Alberto
AU - Pedrotti, Patrizia
AU - Vicenzi, Marco
AU - Sciumbata, Veronica Maria
AU - Cappellini, Maria Domenica
AU - Pierini, Alberto
PY - 2017/9/1
Y1 - 2017/9/1
N2 - Traditional echocardiography is unable to detect neither the early stages of iron overload cardiomyopathy nor myocardial iron deposition. The aim of the study is to determine myocardial systolic strain indices in thalassemia major (TM), and assess their relationship with T2*, a cardiac magnetic resonance index of the severity of cardiac iron overload. 55 TM cases with recent cardiac magnetic resonance (CMR-T2*) underwent speckle tracking analysis to assess regional myocardial strains and rotation. The results were compared with a normal control group (n = 20), and were subsequently analyzed on the basis of the CMR-T2* values. Two TM groups were studied: TM with significant cardiac iron overload (“low” T2*, ≤20 ms; n = 21), and TM with normal T2* values (“normal” T2*, >20 ms; n = 34). TM patients show significant, uniform decrease in circumferential and radial strain (P < 0.05), and a remarkable reduction in end-systolic rotation, both global, and for all segments (P < 0.001). No significant differences were found between the low- and the normal T2* group either in regional strains and rotation or in standard echocardiographic and CMR parameters. Spearman’s correlation coefficient shows no significant correlation between myocardial strains, rotation and cardiac T2* values. In conclusion, our results are in accordance with recent evidence that myocardial iron overload is not the only mechanism underlying iron cardiomyopathy in TM. Strain imaging can predict subclinical myocardial dysfunction irrespective of CMR-T2* values, although it cannot replace CMR-T2* in assessing cardiac iron overload. Finally, it might be useful to appropriately time cardioactive treatment.
AB - Traditional echocardiography is unable to detect neither the early stages of iron overload cardiomyopathy nor myocardial iron deposition. The aim of the study is to determine myocardial systolic strain indices in thalassemia major (TM), and assess their relationship with T2*, a cardiac magnetic resonance index of the severity of cardiac iron overload. 55 TM cases with recent cardiac magnetic resonance (CMR-T2*) underwent speckle tracking analysis to assess regional myocardial strains and rotation. The results were compared with a normal control group (n = 20), and were subsequently analyzed on the basis of the CMR-T2* values. Two TM groups were studied: TM with significant cardiac iron overload (“low” T2*, ≤20 ms; n = 21), and TM with normal T2* values (“normal” T2*, >20 ms; n = 34). TM patients show significant, uniform decrease in circumferential and radial strain (P < 0.05), and a remarkable reduction in end-systolic rotation, both global, and for all segments (P < 0.001). No significant differences were found between the low- and the normal T2* group either in regional strains and rotation or in standard echocardiographic and CMR parameters. Spearman’s correlation coefficient shows no significant correlation between myocardial strains, rotation and cardiac T2* values. In conclusion, our results are in accordance with recent evidence that myocardial iron overload is not the only mechanism underlying iron cardiomyopathy in TM. Strain imaging can predict subclinical myocardial dysfunction irrespective of CMR-T2* values, although it cannot replace CMR-T2* in assessing cardiac iron overload. Finally, it might be useful to appropriately time cardioactive treatment.
KW - Beta-thalassemia major
KW - Cardiac magnetic resonance T2
KW - Iron overload cardiomyopathy
KW - Strain imaging
UR - http://www.scopus.com/inward/record.url?scp=85018321008&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85018321008&partnerID=8YFLogxK
U2 - 10.1007/s11739-017-1670-4
DO - 10.1007/s11739-017-1670-4
M3 - Article
AN - SCOPUS:85018321008
VL - 12
SP - 799
EP - 809
JO - Internal and Emergency Medicine
JF - Internal and Emergency Medicine
SN - 1828-0447
IS - 6
ER -