Abstract
BackgroundDespite advances in survival in patients with thalassemia major (TM) the most common cause of death is cardiac disease. Regular cardiac follow-up is imperative in order to identify and reverse pathology. Cardiac Magnetic Resonance (CMR) and Echocardiography (US) are applied in parallel to TM patients for cardiac evaluation and ongoing monitoring. A comparison between mutual features would be useful in order to assess the accuracy and reliability of the two methods, with a particular focus on routine US application. TM's special attributes offer an excellent opportunity for cardiac imaging research that has universal general purpose applications.Methods135 TM patients underwent US (Teichholz's M-mode formula – rapidly accessible means of measuring volumes and ejection fraction) and CMR volumetry. Paired-samples t-test, Passing & Badlock regression and Bland & Altman plot were used while comparing the common parameters between the CMR and the US.ResultsWe found that the US volumes were underestimated, especially the end-diastolic volume (p < 0.001). The end-systolic volume showed a borderline two-tailed probability (p ≈ 0.05). The correlation for the ejection fraction was acceptable (r = 0.60) without a statistically significant difference (p = 0.37) and the Bland Altman plot range was narrow (25.8%). There was a satisfactory correlation of the US' shortening fraction with CMR's ejection fraction (r = 0.58).ConclusionIn cases where cardiac wall movement abnormalities are absent, the US Teichholz's M-mode formula for volume measurements, though less sophisticated in comparison to the high resolution CMR technique, offers an adequate ejection fraction estimation for routine use, especially when monitoring gross alterations in cardiac function over time, and is easy to perform.
Highlights
Despite advances in survival in patients with thalassemia major (TM) the most common cause of death is cardiac disease
Having in mind the special attributes of this patient population and their need for frequent evaluation of heart performance and cardiac iron load with universal general purpose applications.Echocardiography (US) and Cardiac Magnetic Resonance (CMR) [1], TM offers an excellent opportunity for cardiac imaging research that has universal general purpose applications
Reproducibility is reasonable in normal ventricles [3], but the quantifications of volumes and mass rely on geometrical assumptions that do not apply to ventricles undergoing asymmetric cardiac remodelling such as in cardiomyopathy [4,5]
Summary
Despite advances in survival in patients with thalassemia major (TM) the most common cause of death is cardiac disease. Cardiac Magnetic Resonance (CMR) and Echocardiography (US) are applied in parallel to TM patients for cardiac evaluation and ongoing monitoring. TM's special attributes offer an excellent opportunity for cardiac imaging research that has universal general purpose applications. Transfusion dependent thalassemia (TM) exhibit a broad spectrum of cardiac pathology due to the nature of their disease. Methods of cardiac imaging, such as the US and CMR, assess cardiac function in thalassemia major and estimate the extent of damage. Having in mind the special attributes of this patient population and their need for frequent evaluation of heart performance and cardiac iron load with US and CMR [1], TM offers an excellent opportunity for cardiac imaging research that has universal general purpose applications. Reproducibility is reasonable in normal ventricles [3], but the quantifications of volumes and mass rely on geometrical assumptions that do not apply to ventricles undergoing asymmetric cardiac remodelling such as in cardiomyopathy [4,5] (presence of asynergy and dilatation)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
