Staff Members - Benha University
Early detection of myocardial dysfunction in poorly treated pediatric thalassemia children and adolescents: Two Saudi centers experience
• 2016
Publication Information
Authors
Mohamed H. Ibrahim a, e, Ahmed A. Azab b, f, Naglaa M. Kamal c, f, *, Mostafa A. Salama b, f,
Soha A. Ebrahim b, Ashraf M. Shahin b, Akram E. El-Sadek b, Waleid E. Abdulghany b,
Laila M. Sherief d, Enas A.A. Abdallah
Keywords
Annals of Medicine and Surgery
Journal
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Publisher
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Volume
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Issue
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Pages
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publication.type
International
Paper Link
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Supplementary Materials
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Abstract
Background & Objective: Cardiac complications are among the most serious complications in Beta
Thalassemia Major Patients. Our aim was to evaluate the value of tissue Doppler imaging (TDI) for early
detection of myocardial dysfunction in pediatric and adolescent patients with B-TM before development
of overt heart failure or cardiomyopathy.
Patients and methods: 100 thalassemic patients below 18 years old and 100 healthy, age & sex matched
controls were enrolled in our case-control study. Cases were selected from those attending outpatient
clinics and inpatient wards, King Abdulaziz University hospital and Alhada Armed Forces Hospital, Saudi
Arabia, between January 2014 and January 2015. They were subjected to echo-Doppler examination for
both septal and lateral walls of the basal mitral and tricuspid annuli assessing the systolic myocardial
velocity (S wave), early diastolic myocardial velocity (Ea wave) and late diastolic myocardial velocity (Aa
wave).
Results: Patients with thalassemia have RV and LV dysfunction on the basis of abnormal TDI derived
myocardial velocities. There was a statistically significant differences between patients and controls
regarding (Aa) and (S) of the septal wall of the basal mitral annulus and (Ea) of the lateral wall of the
mitral annulus. Also patients with thalassemia have significantly higher (S) of the basal tricuspid
annulus. These abnormalities were not detected by conventional echo-Doppler.
Conclusion: Clinically asymptomatic thalassemic children and adolescents who had normal global
functions by conventional echo-Doppler were found to have abnormal left ventricular and right ventricular
dysfunctions detected by TDI. TDI is superior to Echo-Doppler in detection of early myocardial
damage in asymptomatic thalassaemic patients.
© 2016 The Authors. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. This is an open
access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Thalassemia Major Patients. Our aim was to evaluate the value of tissue Doppler imaging (TDI) for early
detection of myocardial dysfunction in pediatric and adolescent patients with B-TM before development
of overt heart failure or cardiomyopathy.
Patients and methods: 100 thalassemic patients below 18 years old and 100 healthy, age & sex matched
controls were enrolled in our case-control study. Cases were selected from those attending outpatient
clinics and inpatient wards, King Abdulaziz University hospital and Alhada Armed Forces Hospital, Saudi
Arabia, between January 2014 and January 2015. They were subjected to echo-Doppler examination for
both septal and lateral walls of the basal mitral and tricuspid annuli assessing the systolic myocardial
velocity (S wave), early diastolic myocardial velocity (Ea wave) and late diastolic myocardial velocity (Aa
wave).
Results: Patients with thalassemia have RV and LV dysfunction on the basis of abnormal TDI derived
myocardial velocities. There was a statistically significant differences between patients and controls
regarding (Aa) and (S) of the septal wall of the basal mitral annulus and (Ea) of the lateral wall of the
mitral annulus. Also patients with thalassemia have significantly higher (S) of the basal tricuspid
annulus. These abnormalities were not detected by conventional echo-Doppler.
Conclusion: Clinically asymptomatic thalassemic children and adolescents who had normal global
functions by conventional echo-Doppler were found to have abnormal left ventricular and right ventricular
dysfunctions detected by TDI. TDI is superior to Echo-Doppler in detection of early myocardial
damage in asymptomatic thalassaemic patients.
© 2016 The Authors. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. This is an open
access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).