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Clin Cardiol. 2010 Jul;33(7):E29-34. doi: 10.1002/clc.20584.

Early detection of left ventricular dysfunction with strain imaging in thalassemia patients.

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Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.



Iron-mediated cardiomyopathy is the main cause of death in thalassemia patients. Early detection of cardiac abnormalities is important as aggressive chelation therapy may improve prognosis in these patients. The aim of this study is to evaluate left ventricular (LV) functions by tissue velocity imaging (TVI) and strain imaging (SI) in thalassemia patients without overt heart failure.


At total of 32 patients with beta-thalassemia major (mean age: 24.2+/-8.0 y, 22 male) and 25 healthy controls (mean age: 22.8+/-2.1 y, 20 male) were included. Conventional echocardiography, TVI, and SI were performed on all subjects. Tissue velocity imaging and SI measures included peak systolic, early and late diastolic myocardial velocities, peak systolic strain and strain rate, and early and late diastolic strain rate at the basal segments of the LV lateral and septal walls.


There were no significant differences in LV ejection fraction and fractional shortening between the groups. However, systolic myocardial velocity of the lateral wall and systolic strain and strain rate of the septal and lateral walls were significantly lower in thalassemia patients. There was a significant negative correlation between LV mass index and systolic myocardial velocity of the lateral wall (r = - 0.29, P = .045) and septal systolic strain (r = - 0.45, P < .001).


Thalassemia patients have regional systolic dysfunction in the LV lateral and septal walls, even if they do not have overt heart failure. Strain imaging is helpful in early detection of LV systolic dysfunction in thalassemia patients.

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