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Left Ventricular Systolic Dyssynchrony Index and Endothelial Dysfunction Parameters As Subclinical Predictors of Cardiovascular Involvement in Patients with Beta-Thalassaemia Major
  • +2
  • Hatice Solmaz,
  • Ali Cabuk,
  • zeynep altın,
  • esin özcan,
  • Oner Ozdogan
Hatice Solmaz
Turkiye Cumhuriyeti Saglik Bakanligi Izmir Tepecik Egitim ve Arastirma Hastanesi
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Ali Cabuk
Turkiye Cumhuriyeti Saglik Bakanligi Izmir Tepecik Egitim ve Arastirma Hastanesi
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zeynep altın
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esin özcan
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Oner Ozdogan
Tepecik Training and Research Hospital
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Abstract

Objective: Cardiovascular involvement due to iron overload is the leading cause of morbidity and mortality in patients with beta-thalassaemia major (β-TM). However many patients remain asymptomatic until the late stage. In this study, we investigated the role of real-time three-dimensional echocardiography (RT3DE) findings and endothelial dysfunction parameters in asymptomatic β-TM patients, and the relationship between these parameters and cardiac magnetic resonance imaging (MRI) T2 * value. Methods: 51 asymptomatic β-TM patients who were receiving regular blood transfusions were evaluated by two-dimensional echocardiography (2DE) and RT3DE examinations including endothelial dysfunction parameters. The study population was divided into two subgroups based on their cardiac MRI T2* values (MRI T2* ≤20ms and >20ms). The relationships between serum ferritin levels, 2DE and RT3DE measurements, endothelial dysfunction parameters, and cardiac MRI T2* values were investigated. Results: Although all left ventricle ejection fraction (LVEF) values obtained by 2DE were within normal limits (≥50%), they were not associated with MRI T2* values. LVEFRT3D (53.25 +2.33 vs 58.81 +1.02), SDI12 (6.53 +0.56 vs 2.85 +0.48), SDI16 (7.65 +0.75 vs 3.26 +0.49) were significantly different and negatively correlated between two groups respectively . Flow-mediated dilatation (FMD) (6.08% + 0.34 vs 14.46% + 1.12), aortic strain (7.79% + 2.19 vs 12.76% + 4.19), and serum ferritin values were significantly different and negatively correlated between two groups respectively. Conclusion: Decreased LVEF and increased SDI by RT3DE could be parameters of early cardiac deterioration. Decreased FMD and aortic strain may be good predictors of subclinical cardiovascular involvement in asymptomatic patients with β-TM.

Peer review status:ACCEPTED

04 Dec 2020Submitted to Echocardiography
08 Dec 2020Submission Checks Completed
08 Dec 2020Assigned to Editor
21 Jan 2021Reviewer(s) Assigned
01 Mar 2021Review(s) Completed, Editorial Evaluation Pending
06 Mar 2021Editorial Decision: Revise Major
04 Apr 20211st Revision Received
05 Apr 2021Submission Checks Completed
05 Apr 2021Assigned to Editor
05 Apr 2021Reviewer(s) Assigned
16 Apr 2021Review(s) Completed, Editorial Evaluation Pending
20 Apr 2021Editorial Decision: Accept