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Conference Paper: Myocardial iron load in patients with beta-thalassaemia major is associated with global left ventricular mechanical dyssynchrony

TitleMyocardial iron load in patients with beta-thalassaemia major is associated with global left ventricular mechanical dyssynchrony
Authors
KeywordsEchocardiography
Pediatric cardiology
Issue Date2010
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://circ.ahajournals.org
Citation
The 2010 Scientific Sessions of the American Heart Association (AHA), Chicago, IL., 13-17 November 2010. In Circulation, 2010, v. 122 n. 21 suppl., abstract no. 12192 How to Cite?
AbstractBACKGROUND: Dyssynchronous contraction of the left ventricular (LV) myocardium is increasingly recognized as an important factor that may contribute to global LV systolic dysfunction. This study aimed to test the hypothesis that myocardial iron overloading in patients with beta-thalassaemia major is associated with LV dyssynchrony, which may contribute to global LV systolic dysfunction. METHODS: We studied 38 thalassaemia patients aged 25.1±6.5 years without heart failure and 20 age-matched healthy controls. Real-time 3-dimensional echocardiography was performed to assess LV volumes, ejection fraction, and mechanical dyssynchrony as quantified by the systolic dyssynchrony index (SDI). The 16-segment SDI was derived from the dispersion of time-to-minimum regional volume, expressed as % of cardiac cycle duration. Relationships between SDI and indices of LV systolic function, myocardial iron load as assessed by T2* cardiac magnetic resonance, and carotid arterial stiffness were further determined in patients. RESULTS: Compared with controls, patients had significantly greater LV SDI (5.0±1.0% vs 3.4±0.7%, p<0.001). Mechanical dyssynchrony (SDI>4.8%, control+2SD), documented in 47% of patients, was associated with increased myocardial iron load (p=0.002), reduced LV ejection fraction (p=0.003), lower global LV longitudinal systolic strain (p=0.04), and increased arterial stiffness (p=0.011). Logistic regression identified T2* (p=0.021) and LV ejection fraction (p=0.017) as significant correlates of LV SDI. CONCLUSIONS: Global LV mechanical dyssynchrony occurs with a relatively high prevalence in patients with beta-thalassaemia major and is associated with myocardial iron overload, worse global LV systolic function, and systemic arterial stiffening.
DescriptionCore 1. Cardiovascular Imaging - Session Title: Echocardiography in Clinical Syndromes: Atrial, Aortic and Ventricular Function: abstract A12192
Persistent Identifierhttp://hdl.handle.net/10722/129888
ISSN
2015 Impact Factor: 17.047
2015 SCImago Journal Rankings: 7.853

 

DC FieldValueLanguage
dc.contributor.authorCheung, YFen_US
dc.contributor.authorLiang, XCen_US
dc.contributor.authorChan, GCFen_US
dc.contributor.authorWong, SJen_US
dc.contributor.authorHa, SYen_US
dc.date.accessioned2010-12-23T08:43:51Z-
dc.date.available2010-12-23T08:43:51Z-
dc.date.issued2010en_US
dc.identifier.citationThe 2010 Scientific Sessions of the American Heart Association (AHA), Chicago, IL., 13-17 November 2010. In Circulation, 2010, v. 122 n. 21 suppl., abstract no. 12192en_US
dc.identifier.issn0009-7322-
dc.identifier.urihttp://hdl.handle.net/10722/129888-
dc.descriptionCore 1. Cardiovascular Imaging - Session Title: Echocardiography in Clinical Syndromes: Atrial, Aortic and Ventricular Function: abstract A12192-
dc.description.abstractBACKGROUND: Dyssynchronous contraction of the left ventricular (LV) myocardium is increasingly recognized as an important factor that may contribute to global LV systolic dysfunction. This study aimed to test the hypothesis that myocardial iron overloading in patients with beta-thalassaemia major is associated with LV dyssynchrony, which may contribute to global LV systolic dysfunction. METHODS: We studied 38 thalassaemia patients aged 25.1±6.5 years without heart failure and 20 age-matched healthy controls. Real-time 3-dimensional echocardiography was performed to assess LV volumes, ejection fraction, and mechanical dyssynchrony as quantified by the systolic dyssynchrony index (SDI). The 16-segment SDI was derived from the dispersion of time-to-minimum regional volume, expressed as % of cardiac cycle duration. Relationships between SDI and indices of LV systolic function, myocardial iron load as assessed by T2* cardiac magnetic resonance, and carotid arterial stiffness were further determined in patients. RESULTS: Compared with controls, patients had significantly greater LV SDI (5.0±1.0% vs 3.4±0.7%, p<0.001). Mechanical dyssynchrony (SDI>4.8%, control+2SD), documented in 47% of patients, was associated with increased myocardial iron load (p=0.002), reduced LV ejection fraction (p=0.003), lower global LV longitudinal systolic strain (p=0.04), and increased arterial stiffness (p=0.011). Logistic regression identified T2* (p=0.021) and LV ejection fraction (p=0.017) as significant correlates of LV SDI. CONCLUSIONS: Global LV mechanical dyssynchrony occurs with a relatively high prevalence in patients with beta-thalassaemia major and is associated with myocardial iron overload, worse global LV systolic function, and systemic arterial stiffening.-
dc.languageengen_US
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://circ.ahajournals.org-
dc.relation.ispartofCirculation-
dc.subjectEchocardiography-
dc.subjectPediatric cardiology-
dc.titleMyocardial iron load in patients with beta-thalassaemia major is associated with global left ventricular mechanical dyssynchronyen_US
dc.typeConference_Paperen_US
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0009-7322&volume=122&issue=21 suppl.&spage=&epage=&date=2010&atitle=Myocardial+iron+load+in+patients+with+beta-thalassaemia+major+is+associated+with+global+left+ventricular+mechanical+dyssynchrony-
dc.identifier.emailCheung, YF: xfcheung@hku.hken_US
dc.identifier.emailChan, GCF: gcfchan@hkucc.hku.hken_US
dc.identifier.emailWong, SJ: sjwong@hkucc.hku.hken_US
dc.identifier.emailHa, SY: syha@hkucc.hku.hken_US
dc.identifier.hkuros183554en_US
dc.identifier.volume122-
dc.identifier.issue21 suppl., abstract A12192-
dc.publisher.placeUnited States-
dc.description.otherThe 2010 Scientific Sessions of the American Heart Association, Chicago, MI., 13-17 November 2010. In Circulation, 2010, v. 122 n. 21 suppl., A12192-

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