ASSESSMENT OF LEFT VENTRICULAR DIASTOLIC FUNCTION IN PATIENTS WITH THALASSEMIA MAJOR WITH SPECIAL REFERENCE TO PULSED WAVE TISSUE DOPPLER IMAGING
Dr. G. P. Parale*, Dr. S. S. Vaidya**, Dr. S. R. Shah***
Ashwini Sahakari Rugnalaya & Research Centre, Solapur, Maharashtra.*, Ashwini Sahakari Rugnalaya & Research Centre, Solapur, Maharashtra.**, Ashwini Sahakari Rugnalaya & Research Centre, Solapur, Maharashtra.***
Objective: Cardiac pathology (CCF) secondary to iron deposition, fibrosis, hypertrophy and structural effect of anemia, is major cause of death in chronically transfused patients with ß thalassemia major.

Material & Methods: Present study comprised 30 patients with ß thalassemia major who were evaluated clinically and by 2D Echo, conventional Doppler and by Tissue Doppler imaging for determining LV diastolic function.

Serum Ferritin levels were also studied.
Findings were compared with age and sex matches controls
Difference between continuous variables were determined using unpaired Student's 't' test.

Results:

-

Patient

Control

P-value

Clinical
Age (years)
Sex
Hemoglobin (gm%)
Ferritin (ng/ml)
Average no. of Transfusions/year


10.8 ± 3.1
17F, 18M
8.58 ± 1.44
8370.85 ± 2666.35
16.28 ± 5.5


8.24 ± 2.86
19F, 16M
10.72 ± 0.64
100.55 ± 38.44
Nil


-
-
-
-
2D Echo
EF (%)
LVMI

65.55 ± 8.98
153 ± 54.52

63.87 ± 16.35
1103 ± 29.8

NS
<0.001
Conventional Doppler
E/A
E/Ea
IVRT
DT

1.974 ± 0.729
44.6 ± 19.98
191.5 ± 55.88

2.11 ± 0.93
36.67 ± 5.12
138.5 ± 34.81

NS
0.0001
0.05
Tissue Doppler
E/Ea
10.14 ± 2.07 6.17 ± 2.44
0.0001


Conclusion:
  • Left ventricular diastolic dysfunction is detected in patients with ß thalassemia major even before appearance of systolic dysfunction and clinical features of CCF.
  • No significant corarelation could be established between hematological parameters like serum ferritin, rate of transfusion with Doppler diastolic indices.
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Parale P G D, Vaidya S S D, Shah R S D.. Available From : http://www.pediatriconcall.com/fordoctor/ Conference_abstracts/report.aspx?reportid=239
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