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Determination Of Cardiac Dysfunction By T2 * MRI and Tissue Doppler Echocardiography in Patıents With Thalassemia Major
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  • Melike Sezgin Evim,
  • Özlem Bostan,
  • Aysel Aydın Kaderli,
  • Birol Baytan,
  • Yeşim Özarda,
  • Adalet Meral Güneş
Melike Sezgin Evim
Uludag University Faculty of Medicine
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Özlem Bostan
Uludag University Faculty of Medicine
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Aysel Aydın Kaderli
Medicana Private Hospital,
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Birol Baytan
Uludag University Faculty of Medicine
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Yeşim Özarda
Uludag University Faculty of Medicine
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Adalet Meral Güneş
Uludag University Faculty of Medicine
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Abstract

Background: Tissue Doppler (TD) measurements give a better information in evaluating the myocardial functions than conventional echocardiography in beta-thalassemia major (β-TM). The aim of this study was to determine cardiac status of thalassemia patients by using both T2*MRI and TD. Methods: The study group included thalassemia patients (n=33) with normal systolic functions defined by conventional echocardiography. The control group (n=37) consisted of age and sex matched healthy individuals. TD measurements from three different regions of myocardium were obtained in both groups. Ferritin was examined in both groups, T2*MRI was performed only patients with thalassemia. Results: Systolic and diastolic functions were found normal by conventional echocardiography in thalassemia patients. However, cardiac functions were significantly impaired when evaluated by TD (p<0.05). T2*MRI and TD measurements didn’t differ according to serum ferritin levels (p>0.05). Twenty-one patients (63.6%) had myocardial iron overload. Both isovolumetric acceleration time of left ventricle and myocardial performance index (MPI-septal) were found significantly impaired in these patients (p<0.05). There was negative correlation between MPI-septal and T2*MRI measurements in thalassemia patients (r:-0.343, p=0.050). TD measurements obtained from septum were found similar with the control (p>0.05) but, the same measurements from left and right ventricular walls were significantly impaired in iron unloaded group (p< 0.05). Coclusion: Iron unloaded patients according to T2*MRI had left and right ventricular dysfunction determined by TD. Therefore, we suggest that combining T2*MRI with TD measurements, for evaluating cardiac status in β-TM, in whose with normal T2*MRI scores, would be better management of cardiac complications.