Key result
A global longitudinal strain cutoff of -20.45% predicted cardiac iron loading (T2 < 20 ms) with 83% sensitivity and 54% specificity.
Why the study?
Strain imaging by speckle tracking has been reported as a promising tool to detect early myocardial deformation related to iron overload in β-thalassemia major patients.
Does strain imaging by speckle tracking accurately detect cardiac iron loading compared to T2 MRI in patients with beta-thalassemia major?
Observational (n=45)
Single-blind
No
Does strain imaging by speckle tracking accurately detect cardiac iron loading compared to T2 MRI in patients with beta-thalassemia major?
Strain imaging echocardiography shows potential for predicting cardiac iron accumulation in beta-thalassemia major, though it requires validation in larger cohorts.
Answers are grounded in this paper and cite their sources.
Strain imaging offers modest accuracy for iron overload screening in thalassemia; hypothesis-generating and requires prospective validation before clinical adoption.
Objectives: Strain imaging is a novel promising echocardiographic technique and strain imaging by speckle tracking has been reported recently in a few studies as a promising tool to detect early changes of myocardial deformation that could be related to myocardial iron over load in patients with β-thalassemia major. In this study, we investigated strain images in comparison with the cardiac T2* magnetic resonance imaging results. Materials and Methods: A total of 45 patients from a single institution’s pediatric and adult hematology centers were evaluated with strain echocardiography and T2* magnetic resonance imaging at concomitant out-patient visits. We grouped patients according to cardiac T2* magnetic resonance imaging results: <20 ms (Group 1, cardiac iron loading present) (n=12) and ≥20 ms (Group 2, no clinically significant cardiac iron loading) (n=33). Results: The median global longitudinal strain was measured as -19.9% (range -27.1% to -12%) in Group 1 and -20.7% (range -26.5% to -12.8%) in Group 2 (p=0.37). Using receiver operator curve analysis, global longitudinal strain value at a cutoff point of -20.45% in the ruling out T2*<20 ms with a sensitivity of 83% and a specificity of 54% was obtained. Conclusion: In conclusion, although T2* magnetic resonance imaging is the gold standard method, strain imaging echocardiography can be used for predicting cardiac iron accumulation, after validations were obtained in larger sample sizes.
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Okay et al. (2021) conducted an observational in Beta-thalassemia major (n=45). Global longitudinal strain by speckle tracking echocardiography vs. Cardiac T2 MRI was evaluated on Prediction of cardiac iron loading (T2 < 20 ms) using global longitudinal strain (AUC 0.609, 95% CI 0.406-0.813). A global longitudinal strain cutoff of -20.45% predicted cardiac iron loading (T2 < 20 ms) with 83% sensitivity and 54% specificity.
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