Prevalence of left ventricular diastolic dysfunction by cardiac magnetic resonance imaging in thalassemia major patients with normal left ventricular systolic function.
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 articlePermalink
https://hdl.handle.net/10161/19557Published Version (Please cite this version)
10.1186/s12872-019-1235-8Publication 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.
Collections
More Info
Show full item recordScholars@Duke
Yodying Kaolawanich
Visiting Research Scholar in the Department of Medicine

Articles written by Duke faculty are made available through the campus open access policy. For more information see: Duke Open Access Policy
Rights for Collection: Scholarly Articles