Key result
Abnormal cardiac iron load in β-thalassemia was associated with lower global longitudinal strain, with a GLS cutoff of -18.5% predicting T2 <20 ms.
Why the study?
Does left ventricular global longitudinal strain correlate with cardiac magnetic resonance T2 to predict myocardial iron overload in individuals with β-thalassemia?
Cross-Sectional (n=130)
Does left ventricular global longitudinal strain correlate with cardiac magnetic resonance T2 to predict myocardial iron overload in individuals with β-thalassemia?
Global longitudinal strain via echocardiography is a useful and accessible tool to predict myocardial iron overload in patients with β-thalassemia, correlating significantly with the gold-standard cardiac MRI T2.
Answers are grounded in this paper and cite their sources.
GLS may aid noninvasive detection of iron overload in β-thalassemia; hypothesis-generating and requires prospective validation.
BACKGROUND: Heart failure is the biggest cause of mortality and morbidity in people with thalassemia, and iron deposition in cardiac tissue impairs cardiovascular function. Therefore, early detection of cardiac involvement is important to improve the prognosis in these individuals. METHOD: Two- and three-dimensional echocardiography was performed to evaluate left ventricular ejection fraction (LVEF), left ventricular volumes and diameters, and global longitudinal strain (GLS) in 130 individuals with β-thalassemia using the speckle tracking method. Magnetic resonance imaging (MRI) was carried out on both the heart and liver. The participants were divided into 2 groups based on cardiac T2* values (normal and abnormal cardiac iron load), and the correlation between cardiac T2* MRI and GLS was evaluated. RESULTS: The statistical analysis showed a significant correlation between cardiac T2* MRI and left ventricular global longitudinal strain. There was a significant difference in global longitudinal strain (P < .0001), liver MRI T2*( P < .0001), and left ventricular ejection fraction (P < .001) between the 2 groups. The optimal cutoff value for GLS was -18.5% with sensitivity and specificity 73.0% and 63.0%, respectively (postitive predictive value = 50%, negative predictive value = 82.3%, AUC = 0.742, std. error = 0.046) which predicts T2* value of <20 ms, according to cardiac MRI. CONCLUSIONS: The participants with cardiac iron overload had a lower GLS than those without one. This suggests that GLS may be a useful method to predict myocardial iron overload particularly in β-thalassemia patients with subclinical cardiac involvement.
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Parsaee et al. (2018) conducted a cross-sectional in β-thalassemia (n=130). Abnormal cardiac iron load vs. Normal cardiac iron load was evaluated on Left ventricular global longitudinal strain (GLS) (AUC 0.742, p=<.0001). Abnormal cardiac iron load in β-thalassemia was associated with lower global longitudinal strain, with a GLS cutoff of -18.5% predicting T2 <20 ms.
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