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    Prevalence of left ventricular diastolic dysfunction by cardiac magnetic resonance imaging in thalassemia major patients with normal left ventricular systolic function.

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    Date
    2019-11-06
    Authors
    Kaolawanich, Yodying
    Chinprateep, Benjaporn
    Ratanasit, Nithima
    Karaketklang, Khemajira
    Saiviroonporn, Pairash
    Viprakasit, Vip
    Krittayaphong, Rungroj
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    Abstract
    BACKGROUND:The leading cause of mortality of thalassemia major patients is iron overload cardiomyopathy. Early diagnosis with searching for left ventricular diastolic dysfunction before the systolic dysfunction ensued might yield better prognosis. This study aimed to define the prevalence of the left ventricular diastolic dysfunction (LVDD) in thalassemia major patients with normal left ventricular systolic function and the associated factors. METHODS:Adult thalassemia major patients with normal left ventricular systolic function who were referred for cardiac T2* at Siriraj Hospital - Thailand's largest national tertiary referral center - during the October 2014 to January 2017 study period. Left ventricular diastolic function was defined by mitral valve filling parameters and left atrial volume index using CMR. Patients with moderate to severe valvular heart disease, pericardial disease, or incomplete data were excluded. Baseline characteristics, comorbid diseases, current medication, and laboratory results were recorded and analyzed. RESULTS:One hundred and sixteen patients were included, with a mean age of 27.5 ± 13.5 years, 57.8% were female, and 87.9% were transfusion dependent. Proportions of homozygous beta-thalassemia and beta-thalassemia hemoglobin E were 12.1 and 87.9%, respectively. The baseline hematocrit was 26.3 ± 3.3%. The prevalence of LVDD was 20.7% (95% CI: 13.7-29.2%). Cardiac T2* was abnormal in 7.8% (95% CI: 3.6-14.2%). Multivariate analysis revealed age, body surface area, homozygous beta-thalassemia, splenectomy, heart rate, and diastolic blood pressure to be significantly associated with LVDD. CONCLUSIONS:LVDD already exists from the early stages of the disease before the abnormal heart T2 * is detected. Homozygous beta-thalassemia and splenectomy were strong predictors of LVDD. These data may increase awareness of the disease, especially in the high risk groups.
    Type
    Journal article
    Subject
    Cardiac magnetic resonance imaging
    Left ventricular diastolic dysfunction
    Thalassemia
    Permalink
    https://hdl.handle.net/10161/19557
    Published Version (Please cite this version)
    10.1186/s12872-019-1235-8
    Publication Info
    Kaolawanich, Yodying; Chinprateep, Benjaporn; Ratanasit, Nithima; Karaketklang, Khemajira; Saiviroonporn, Pairash; Viprakasit, Vip; & Krittayaphong, Rungroj (2019). Prevalence of left ventricular diastolic dysfunction by cardiac magnetic resonance imaging in thalassemia major patients with normal left ventricular systolic function. BMC cardiovascular disorders, 19(1). pp. 245. 10.1186/s12872-019-1235-8. Retrieved from https://hdl.handle.net/10161/19557.
    This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
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    Scholars@Duke

    Yodying Kaolawanich

    Visiting Research Scholar in the Department of Medicine
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