Children with transfusion-dependent beta-thalassemia exhibited significantly impaired global longitudinal strain (-18.56% vs -21.47%, p<0.001) and ventricular dilation compared to matched controls.
Case-Control (n=100)
Does three-dimensional echocardiography and speckle-tracking strain analysis improve the detection of early subclinical left ventricular dysfunction compared to conventional 2D echocardiography in children with transfusion-dependent beta-thalassemia?
3D echocardiography and speckle-tracking strain analysis can detect early subclinical left ventricular dysfunction in children with transfusion-dependent beta-thalassemia despite preserved conventional 2D systolic indices.
Absolute Event Rate: -18.56% vs -21.47%
p-value: p=<0.001
Background: Left ventricular (LV) dysfunction remains the leading cause of mortality in transfusion-dependent beta-thalassemia (TDßT), yet conventional echocardiography often fails to detect early myocardial impairment. This study aimed to comprehensively evaluate LV function in children with TDßT using three-dimensional echocardiography (3DE) and speckle-tracking strain analysis, comparing diagnostic performance with conventional two-dimensional (2D) parameters. Results: 50 TDßT patients were compared to 50 matched controls and exhibited preserved conventional LV ejection fraction (EF) on 2D (65.31 ± 7.12% vs. 69.21 ± 3.87%, p = 0.001), but 3DE revealed significant ventricular dilation with higher end-diastolic volume index (75.50 ± 17.99 vs. 65.63 ± 11.86 mL/m2, p = 0.002) and end-systolic volume index (22.28 ± 7.85 vs. 18.21 ± 5.14 mL/m2, p = 0.003). Despite preserved 3D EF (70.79 ± 5.98% vs. 72.07 ± 5.76%, p = 0.276), global longitudinal strain (GLS) was significantly impaired (−18.56 ± 2.37% vs. −21.47 ± 1.86%, p < 0.001). 3D volumetric parameters demonstrated superior diagnostic performance (AUC for LVEDVI Z-score = 0.874) compared to conventional indices. Transfusion duration correlated strongly with ventricular volumes (r = 0.569 for EDV, p < 0.001), while serum ferritin showed no significant correlation with cardiac parameters. Conclusions: Children with TDßT develop early subclinical LV dysfunction detectable by 3DE and strain analysis despite preserved conventional systolic indices. 3D volumetry and GLS should be integrated into routine cardiac surveillance protocols to enable timely therapeutic intervention.
Raafat et al. (Fri,) conducted a case-control in Transfusion-dependent beta-thalassemia (n=100). Transfusion-dependent beta-thalassemia vs. Matched controls was evaluated on Global longitudinal strain (GLS) (p=<0.001). Children with transfusion-dependent beta-thalassemia exhibited significantly impaired global longitudinal strain (-18.56% vs -21.47%, p<0.001) and ventricular dilation compared to matched controls.