Can 2D speckle tracking echocardiography be useful in venesection therapy monitoring in hereditary hemochromatosis patients?

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Abstract Funding Acknowledgements Type of funding sources: None. Background. Hereditary hemochromatosis (HH) is a widespread genetic disease. Abnormally increased intestinal iron absorption and accelerated recycling of iron lead to progressive body iron accumulation and the generation of oxidative stress in tissues. Venesection is the primary treatment of such patients. Based on the fact that two-dimensional speckle tracking echocardiography (2D STE) can evaluate left ventricle (LV) dysfunction more accurately and earlier than conventional echocardiography, the purpose of our study was to check whether it could be helpful in venesection therapy monitoring. Methods. We prospectively enrolled 20 patients with genetically confirmed HH. Classic echocardiographic and 2D STE parameters (GE VIVID E9, EchoPAC v202) were analyzed at the moment of diagnosis, and after three years of treatment with venesection; 20 healthy age- and sex-matched persons constituted the control group. Results. The HH patients had all standard echo parameters within the normal range at the first and second examinations. The rotation parameters were initially worse than in healthy people at the first visit and significantly increased after three years of treatment. The radial strain after the treatment was significantly better for the apex but not for basal LV, apart from the epicardial layer (known as the layer of iron overload in the heart). Global longitudinal strain (GLS), significantly lower than in healthy people at the first visit, did not change within the treatment (Table). Conclusions. Venesection leads to significant improvement in the rotation function of LV and increases radial strain mainly in the epicardium, which seems to help monitor the treatment and guide the intensity of venesections. GLS, which is known as a parameter for early detection of heart abnormalities in asymptomatic HH patients, did not increase within the treatment and could reveal irreversible changes in LV. Abstract Figure.