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May 1, 2022Annals of Pediatric CardiologyOpen Access

A two-dimensional speckle-tracking echocardiography for the diagnosis of early myocardial disease in beta-thalassemia major patients

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Key result

Beta-thalassemia major patients had significantly reduced global longitudinal peak systolic strain compared to healthy controls, with a cutoff of ≤-19 demonstrating 90% sensitivity and 100% specificity for detecting subclinical cardiac iron overload.

Why the study?

Routine MRI T2* for myocardial iron overload in beta-thalassemia is limited by cost and availability, prompting evaluation of two-dimensional speckle-tracking echocardiography for early myocardial disease detection.

Does 2D speckle-tracking echocardiography detect subclinical cardiac iron overload in beta-thalassemia major patients?

Population

30 beta-thalassemia major patients with no clinical heart disease and 30 healthy age- and sex-matched controls

Comparison

Beta-thalassemia major patients vs healthy controls

Design

Case-control study

Authors

ATAzza Abdel Gawad TantawyNENayera H. K. ElsherifNHNeveen M. Habeeb

Discussion

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Overview

STE may detect early LV dysfunction in thalassemia; leaves open validation against T2* MRI before routine use.

Study Design

Type

Cross-Sectional (n=60)

Blinding

Blinded assessors

Multicenter

No

Structured PICO

Does 2D speckle-tracking echocardiography detect subclinical cardiac iron overload in beta-thalassemia major patients?

P
Population
60 adolescents (30 with beta-thalassemia major without clinical heart failure and 30 healthy matched controls) evaluated for early myocardial disease using 2D speckle-tracking echocardiography.
E
Exposure
Two-dimensional (2D) speckle-tracking echocardiography (STE)
C
Comparator
Healthy controls and magnetic resonance imaging (MRI) T2* (as gold standard)
O
Outcome
Detection of subclinical cardiac iron overloadsurrogate

Main Result

Absolute Event Rate: -19.2% vs -22%

p-value: p=0.001

2D speckle-tracking echocardiography is a sensitive and specific alternative to MRI T2* for detecting early subclinical myocardial iron overload in beta-thalassemia major patients.

Limitations

  • Relatively small sample size
  • Absence of statistical analysis of the inter- and intra-observer variability to evaluate the reproducibility of STE
  • Did not use three-dimensional (3D) STE which may be more capable of assessing actual global myocardial deformation
  • Small sample size
  • Intra-and inter-observer variability not assessed

Cite This Study

Tantawy et al. (2022) conducted a cross-sectional in Beta-thalassemia major (n=60). Beta-thalassemia major vs. Healthy controls was evaluated on Global longitudinal peak systolic strain average (GLPS AVG) (p=0.001). Beta-thalassemia major patients had significantly reduced global longitudinal peak systolic strain compared to healthy controls, with a cutoff of ≤-19 demonstrating 90% sensitivity and 100% specificity for detecting subclinical cardiac iron overload.

synapsesocial.com/papers/6a7dc9b97c193befc4339fbbhttps://doi.org/10.4103/apc.apc_91_21
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Comparison between three-dimensional speckle-tracking echocardiography and cardiac magnetic resonance imaging for quantification of left ventricular volumes and function2012 · 113 citations
  2. 2Myocardial T2* is not affected by ageing, myocardial fibrosis, or impaired left ventricular function2010 · 22 citations
  3. 3Echocardiographic quantification of myocardial function using tissue deformation imaging, a guide to image acquisition and analysis using tissue Doppler and speckle tracking2007 · 371 citations
  4. 4Role of Speckle Tracking Echocardiography in Dilated Cardiomyopathy: A Review2017 · 20 citations
  5. 5Ventricular global longitudinal strain is altered in children with sickle cell disease2018 · 16 citations