Speckle-tracking echocardiography as screening tool for myocardial fibrosis and Iron overload in transfusion-dependent beta-thalassemia.
Int J Cardiol
; : 132616, 2024 Oct 03.
Article
en En
| MEDLINE
| ID: mdl-39368652
ABSTRACT
BACKGROUND:
Transfusion-dependent beta thalassemia (TDT) is a genetic disorder characterized by low haemoglobin levels, often leading to myocardial iron overload (MIO) and myocardial fibrosis (MF). Cardiac Magnetic Resonance (CMR) represents the gold standard for MIO and MF assessment, although its limited availability and high costs pose challenges. Left Ventricular Global Longitudinal Strain (LV GLS) measured by Speckle Tracking Echocardiography (STE) could offer a valuable alternative.METHODS:
A monocentric diagnostic accuracy study was conducted to compare the performance of LV GLS with CMR using T2* for evaluating MIO and late gadolinium enhancement (LGE) for detecting MF. Between January 2022 and January 2023, 44 consecutive patients with TDT were enrolled. For each participant was performed LV GLS with STE, including CMR with T2* technique and LGE sequences.RESULTS:
CMR identified MIO in 8 patients (18â¯%) and MF in 5 (11â¯%). LV GLS STE was normal in patients without MIO (-20.6⯱â¯3.1â¯%) or MF (-20.6⯱â¯2.8â¯%), significantly differing from those with MIO (-18.2⯱â¯2.1â¯%, pâ¯=â¯0.043) and MF (-16.4⯱â¯1.7â¯%, pâ¯=â¯0.002). ROC analysis indicated an optimal LV GLS STE cutoff of -19.8â¯% for MIO (AUCâ¯=â¯0.76, 95â¯% CI 0.59-0.93, pâ¯=â¯0.054) with an overall diagnostic accuracy of 64â¯% and an optimal cutoff of -18.3â¯% for MF (AUCâ¯=â¯0.93, 95â¯% CI 0.85-1.00, pâ¯=â¯0.009) with an accuracy of 86â¯%.CONCLUSIONS:
The findings of this pilot study indicate that LV GLS with STE, may be a cost-effective screening tool for the early detection of MIO and MF in TDT patients.
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Colección:
01-internacional
Base de datos:
MEDLINE
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En
Revista:
Int J Cardiol
Año:
2024
Tipo del documento:
Article
Pais de publicación:
Países Bajos