Examination of echocardiographic parameters for the early diagnosis of cardiac dysfunction in beta thalassemia major patients

Objective: This study aimed to determine the utility of tissue Doppler, pulse-wave Doppler, and conventional echocardiography for the detection of cardiac dysfunction in the early period in beta thalassemia patients. Methods: Forty beta thalassemia major patients undergoing regular blood transfusion and chelation therapy and 30 healthy controls with similar demographic factors were included in the study. Both the patient and control groups were examined with, tissue Doppler, pulse-wave Doppler, motion-mode echocardiography. Ferritin values and T2* magnetic resonance measurements were recorded for those in the patient group. Results: Diastolic dysfunction indicators like early ventricular filling rate, atrial contraction rate, mitral A wave time, and reverse pulmonary venous flow velocity were higher in the patient group (p<0.001, p=0.003, p<0.001, p=0.006, respectively), the deceleration time and pulmonary venous systolic flow velocity (p=0.035, p=0.033, respectively) were lower. Moreover, in thalassemia major patients, there were significant increases in the ratios of early ventricular filling rate to early diastolic myocardial rate in the lateral, basal and mid septal walls (p<0.001, p=0.001, p=0.012, respectively). While the difference between the ferritin values and echocardiographic data was not significant in patient, it was significant between patients with severe and no cardiac iron load regarding an increase in left ventricular end-diastolic thickness and a decrease in left ventricular ejection fraction values (p=0.045, p=0.049, respectively). Conclusions: In beta-thalassemia major patients, tissue Doppler, pulse-wave Doppler and conventional echocardiography can be used to detect cardiac dysfunction in the early periods in cases where T2* magnetic resonance is not available.