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February 5, 2021Acta MedicaOpen Access

Strain Imaging by Speckle Tracking for the Assessment of Diastolic Dysfunction in Beta-Thalassemia Major Patients

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Key result

A global longitudinal strain cutoff of -20.45% predicted cardiac iron loading (T2* < 20 ms) with 83% sensitivity and 54% specificity (AUC 0.609).

Why the study?

Does strain imaging by speckle tracking accurately detect cardiac iron loading compared to T2* MRI in patients with beta-thalassemia major?

Population

45 pediatric and adult patients with beta-thalassemia major from a single institution

Comparison

Strain imaging by speckle tracking… vs Cardiac T2* magnetic resonance imaging

Design

Cross-sectional

Authors

MOMüfide OkayCÇCem ÇöteliTHTuncay Hazırolan

Discussion

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Overview

Strain imaging offers modest accuracy for iron overload screening in thalassemia; hypothesis-generating and requires prospective validation before clinical adoption.

Study Design

Type

Observational (n=45)

Blinding

Single-blind

Multicenter

No

Structured PICO

Does strain imaging by speckle tracking accurately detect cardiac iron loading compared to T2* MRI in patients with beta-thalassemia major?

P
Population
45 adult patients with beta-thalassemia major on regular transfusion programs evaluated with strain echocardiography and T2* MRI at a single center.
E
Exposure
Strain imaging by speckle tracking echocardiography
C
Comparator
Cardiac T2* magnetic resonance imaging
O
Outcome
Global longitudinal strain (GLS) and diagnostic accuracy for detecting cardiac iron loading (T2* <20 ms)surrogate

Main Result

Effect estimate: AUC 0.609 (95% CI 0.406-0.813)

Strain imaging echocardiography shows potential for predicting cardiac iron accumulation in beta-thalassemia major, though it requires validation in larger cohorts.

Limitations

  • Small study population due to rarity of the BTM
  • Measurement of iron burden was made only in the mid ventricular septum
  • small sample size

Cite This Study

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 (AUC 0.609).

synapsesocial.com/papers/6ab33e8cb76ae2ddf6deb2a5https://doi.org/10.32552/2021.actamedica.533
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Also Consider

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

  1. 1Use of strain, strain rate, tissue velocity imaging, and endothelial function for early detection of cardiovascular involvement in patients with beta-thalassemia2017 · 11 citations
  2. 2Left ventricular diastolic Doppler characteristics in beta-thalassemia major.1993 · 182 citations
  3. 3Standardization of adult transthoracic echocardiography reporting in agreement with recent chamber quantification, diastolic function, and heart valve disease recommendations: an expert consensus document of the European Association of Cardiovascular Imaging2017 · 857 citations
  4. 4Journal of The American College of Cardiology2015 · 2,619 citations
  5. 5How I treat transfusional iron overload2012 · 208 citations