P902 Abnormal diastolic function in patients with transfusion dependant thalassemia major

Abstract

Abstract Aim and Background Cardiac complications secondary to iron deposition are the commonest cause of death in patients with beta thalassemia major (TM) and can cause various abnormalities. The aim of this study was to assess the diastolic function in patients with transfusion dependant TM and compare with normal controls. Methods This was a retrospective study involving patients with transfusion dependant TM , on chelation therapy who had a MRI T2* and a transthoracic echocardiogram during the preceeding 6 months. We compared the findings with those from normal controls. We also correlated the echo findings with the MRI T2* values. Results Patients with TM (n = 92, 45% male, mean age 26+ 6 years), with median MRI T2* of 32 (18-39) and normal LV function had signs of diastolic dysfunction as compared to normal controls (41% male, mean age 25 + 6 years) with E/E’ at 6.6 + 1.6 vs 5.5 +1.2 (p < 0.001) and altered pulmonary vein s/d ratio (0.88 + 0.30 vs 1.04 +0.42 for controls, p = 0.02)even in the presence of normal LV systolic function (Ejection fraction 61+ 7% vs 3.4% for controls). There was no difference in the other dimensions. The E/A ratio also corelated well with the MRI T2* (spearmans correlation rho -0.226 p 0.04). There were no other significant correlations between either the MRI T2* or myocardial Iron concentration and any of the other echo parameters Conclusion In patients with TM signs of diastolic dysfunction appear before LV systolic dysfunction and may be used to monitor these patients in absence of MRI facilities. Echo findings in thalassemia Controls (n= 53) Thalassemia Major (n = 92) P value Sex Male Female 22 (41%) 31(59%) 42(45%) 50(55%) 0.5 Mitral E 0.84 + 0.16 1.01 + 0.16 <0.001 Mitral A 0.47 +0.11 0.55 +0.16 <0.001 E/A 1.85 +0.52 1.98 + 0.71 0.24 TDseptal 13.1 + 2.6 13.2 + 3.4 0.9 TDlateral 17.1+ 3.3 17.3 +4.1 0.7 E/E’ 5.5 +1.2 6.6 + 1.6 <0.001 PVs/d 1.04 + 0.41 0.88 +0.30 0.02 TD= tissue doppler; PV- pulmonary vein