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Detection of myocardial iron overload by two-dimensional speckle tracking in patients with beta-thalassaemia major: a combined echocardiographic and T2* segmental CMR study

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Abstract

We aimed to evaluate the role of two-dimensional speckle tracking imaging (2DSTI) in detecting early changes of myocardial deformation in patients affected by thalassemia major (TM) and its relation with myocardial iron overload (MIO) detected by T2* cardiovascular magnetic resonance (CMR). We studied 28 TM patients (15 males, 37.4 ± 10 years). All patients underwent CMR and echocardiography in the same day. Segmental and global T2* values were measured. Values of global longitudinal strain (GLS) were derived from the three apical views, while radial and circumferential strain were obtained as average strain from the short axis views at basal, mid and apical level. Six patients (21.4%) showed significant MIO (global heart T2* < 20 ms). GLS showed a significant correlation with T2* values (R = −0.49; P = 0.001) and it was significantly lower in patients with a significant MIO than in those with no significant MIO (−18.3 ± 2 vs. −21.3 ± 2.7, P = 0.02). No significant difference was found for radial and circumferential strain in relation to the severity of MIO. Patients with impaired GLS (<−19.5%) had a significant higher risk of showing significant MIO (Odds-ratio-OR = 17; 95%). GLS is related with global T2* in TM patients. Moreover, GLS can identify TM patients with severe MIO detected by CMR.

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Acknowledgements

We thank all patients for their cooperation. We also thank the technical radiologists, the nurses and the secretary for their support in this study.

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Authors and Affiliations

  1. Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, AOU “Policlinico G. Martino”, Messina, Italy

    Fausto Pizzino, Anna Terrizzi, Concetta Zito, Scipione Carerj & Gianluca Di Bella

  2. Magnetic Resonance Imaging Unit, Fondazione G. Monasterio CNR-Regione Toscana, Area della Ricerca S. Cataldo, Via Moruzzi, 1, 56124, Pisa, Italy

    Fausto Pizzino, Antonella Meloni, Giovanni Donato Aquaro & Alessia Pepe

  3. Medical and Surgical Pathologies of the Heart Unit, Fondazione G. Monasterio CNR-Regione Toscana, Massa, Italy

    Fausto Pizzino

  4. Centro Talassemie ed Emoglobinopatie, Ospedale “Meyer”, Firenze, Italy

    Tommaso Casini

  5. U.O.S.D. Centro per le Microcitemie, AORN Cardarelli, Napoli, Italy

    Anna Spasiano

  6. Clinica Pediatrica, Azienda Ospedaliero-Universitaria di Sassari, Sassari, Italy

    Carlo Cosmi

  7. Servizio Microcitemia, Presidio Ospedaliero ASL 5, Crotone, Italy

    Massimo Allò

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  1. Fausto Pizzino
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  2. Antonella Meloni
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Correspondence to Alessia Pepe.

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The MIOT project received ‘no-profit support’ from Chiesi Farmaceutici S.p.A., Apopharma Inc and Bayer S.P.A.

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Pizzino, F., Meloni, A., Terrizzi, A. et al. Detection of myocardial iron overload by two-dimensional speckle tracking in patients with beta-thalassaemia major: a combined echocardiographic and T2* segmental CMR study. Int J Cardiovasc Imaging 34, 263–271 (2018). https://doi.org/10.1007/s10554-017-1219-7

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