title: Diastolic function in young patients with beta-thalassemia major: an echocardiographic study.
abstract: OBJECTIVE
  We aimed to evaluate myocardial diastolic function in patients with beta-thalassemia major (beta-TM) using pulsed-tissue Doppler imaging (TDI) and flow propagation (VP), in relation to BNP levels.
  
  
  METHODS
  We enrolled 192 consecutive patients with beta-TM (88 men (25 +/- 6 years) and 104 women (26 +/- 6 years), with normal left ventricular (LV) systolic function. By TDI, diastolic myocardial velocities were sampled at the lateral section of the mitral annulus (Smv, Emv, Amv). From the apical four-chamber view diastolic transmitral flow velocities, including measures of E- and A-waves were performed. The propagation velocity of early flow into the LV cavity was measured by color M-mode Doppler. Plasma BNP levels were measured in all patients.
  
  
  RESULTS
  A nonlinear relationship was found between BNP levels and E/A ratio (beta coefficient for the second-order term = 1.4 +/- 0.4, P = 0.001). We also found a positive association of BNP levels with Amv (r = 0.28, P = 0.023), and a reverse with Smv (r =-0.59, P = 0.01) and Emv/Amv (r =-0.36, P = 0.019). Moreover, an inverse relationship was observed between BNP and Vp (r =-0.43, P = 0.012) levels. Finally, a strong positive linear relationship was found between E/Vp ratio and BNP levels (r = 0.76, P < 0.001).
  
  
  CONCLUSIONS
  A U-curved association of E/A ratio of transmitral Doppler velocity was revealed with BNP levels, while the tissue Doppler of the Emv/Amv of the mitral annulus movement showed a negative linear association with BNP levels.
authors.affiliation: First Cardiology Clinic, University of Athens, Athens, Greece. chrysohoou@usa.net
authors.forename: Christina
authors.initials: C
authors.lastname: Chrysohoou
authors.forename: Michael
authors.initials: M
authors.lastname: Greenberg
authors.forename: Christos
authors.initials: C
authors.lastname: Pitsavos
authors.forename: Demosthenes B
authors.initials: DB
authors.lastname: Panagiotakos
authors.forename: Vasilios
authors.initials: V
authors.lastname: Ladis
authors.forename: John
authors.initials: J
authors.lastname: Barbetseas
authors.forename: Stella
authors.initials: S
authors.lastname: Brili
authors.forename: Steven
authors.initials: S
authors.lastname: Singh
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Stefanadis
mesh_terms: D000328:Adult; D000367:Age Factors; D003971:Diastole; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D013599:Systole; D016277:Ventricular Function, Left / Q000502:physiology*; D017086:beta-Thalassemia / Q000097:blood / Q000000981:diagnostic imaging*
chemical_list: D020097:Natriuretic Peptide, Brain