Important Echocardiographic Parameters in Early Detection of Cardiac Involvement of Patients Suffering from Thalassemia Major

Background- Cardiac involvement is one of the most common causes of morbidity and mortality in patients with thalassemia major. In this study the echocardiographic parameters which would predict cardiac involvement in the patients at an early stage were determined. Methods-A case control study was designed on 80 patients suffering from thalassemia major from September 2002 to December 2003 at a pediatric hospital. The following parameters were measured in the case group and age and sex-matched control group: isovolumic ventricular relaxation time (IVRT), deceleration time (DT), and pre-ejection period to ejection time (PEP/ET). Data were analyzed by T-student test and correlation coefficient. Results- The mean age of the patients was 14.3پ}2.3 years, and age of the control group was 14پ}2.6 years. Mean ejection fraction in the case and control groups were 55.7پ}7.2 and 62.8پ}7.7 percent, respectively (p<0.001). Mean IVRT of the left ventricle was 126.21پ} 22.4 in the case group and 95.31پ}11.7 in the control group, (p<0.05). DT of the mitral valve in the case group was 144.67پ}23, in comparison to 141پ}30 (p>0.05) in the controls. Mean right ventricular IVRT in the case group was 128.18پ}21.62, and 98.32پ}15.16 (p<0.05) in the control group. Tricuspid valve DT in the case group was 134.87پ}25, and 144.93پ}20, (p<0.05) in the control group. PEP/ET in the left heart in the case group was 0.32پ}0.06, and 0.28پ}0.004 (p<0.05) in the control group. PEP/ET in the right side of the heart in the case group was 0.31پ}0.06 and in the control group, it was 0.26پ}0.04, (p<0.05). Conclusion- The data show that IVRT in both ventricles regressed to the same extent, also decreased DT and increased PEP/ET in the right heart shows earlier right-sided failure (Iranian Heart Journal 2006; 7 (3):20-24).