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Left and Right Atrial Function and Remodeling in Beta-Thalassaemia Major

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Abstract

This study aimed to assess left (LA) and right atrial (RA) function in patients with beta-thalassaemia major. Thirty-eight patients (19 males) aged 34.5 ± 10.7 years and 43 (18 males) controls aged 30.3 ± 12.6 years (p = 0.12) were studied. The maximum RA and LA areas were measured using two-dimensional planimetry, while atrial and ventricular strain and strain rates were quantified using speckle-tracking echocardiography. Compared with controls, patients had significantly reduced LA and RA peak positive strain and total strain, and LA strain rate during ventricular systole and at atrial contraction (all p < 0.05). The LA and RA strain parameters were significantly associated (all p < 0.05). The maximum LA (10.2 ± 1.6 cm2/m2 vs. 8.6 ± 1.3 cm2/m2, p < 0.001) and RA (9.2 ± 1.2 cm2/m2 vs. 7.5 ± 1.3 cm2/m2, p < 0.001) areas were significantly greater in patients than controls. The LV and RV strain and early strain rates were similar between patients and controls (all p > 0.05). Four patients with significant myocardial iron overload had larger LA area (p < 0.001) than those without. Functional and structural remodeling of both the right and left atria occurs in patients with beta-thalassaemia major, even in the absence of ventricular diastolic dysfunction.

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Acknowledgements

The Children’s Thalassaemia Foundation, Hong Kong, China.

Funding

This study is supported by the Children’s Thalassaemia Foundation, Hong Kong, China (Grant no. 2015/07).

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Authors and Affiliations

  1. Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China

    Yiu-fai Cheung, Edwina Kam-fung So, Gloria Yu-yan Hwang, Godfrey Chi-fung Chan & Shau-yin Ha

  2. Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China

    Yiu-fai Cheung, Edwina Kam-fung So, Gloria Yu-yan Hwang, Godfrey Chi-fung Chan & Shau-yin Ha

  3. Division of Paediatric Cardiology, Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, The University of Hong Kong, 102, Pokfulam Road, Hong Kong, China

    Yiu-fai Cheung

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  1. Yiu-fai Cheung
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  2. Edwina Kam-fung So
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Corresponding author

Correspondence to Yiu-fai Cheung.

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All of the authors declare no conflict of interest.

Ethical Approval

The review of records and echocardiographic assessment in all of the study subjects and the need to obtain informed consent, was approved by the Institutional Review Board of the University of Hong Kong/Hospital Authority Hong Kong West Cluster, Hong Kong, China, and in accordance with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Cheung, Yf., So, E.Kf., Hwang, G.Yy. et al. Left and Right Atrial Function and Remodeling in Beta-Thalassaemia Major. Pediatr Cardiol 40, 1001–1008 (2019). https://doi.org/10.1007/s00246-019-02105-3

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  • DOI: https://doi.org/10.1007/s00246-019-02105-3

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