title: Comparison of echocardiographic (US) volumetry with cardiac magnetic resonance (CMR) imaging in transfusion dependent thalassemia major (TM).
abstract: BACKGROUND
  Despite advances in survival in patients with thalassemia major (TM) the most common cause of death is cardiac disease. Regular cardiac follow-up is imperative in order to identify and reverse pathology. Cardiac Magnetic Resonance (CMR) and Echocardiography (US) are applied in parallel to TM patients for cardiac evaluation and ongoing monitoring. A comparison between mutual features would be useful in order to assess the accuracy and reliability of the two methods, with a particular focus on routine US application. TM's special attributes offer an excellent opportunity for cardiac imaging research that has universal general purpose applications.
  
  
  METHODS
  135 TM patients underwent US (Teichholz's M-mode formula - rapidly accessible means of measuring volumes and ejection fraction) and CMR volumetry. Paired-samples t-test, Passing & Badlock regression and Bland & Altman plot were used while comparing the common parameters between the CMR and the US.
  
  
  RESULTS
  We found that the US volumes were underestimated, especially the end-diastolic volume (p < 0.001). The end-systolic volume showed a borderline two-tailed probability (p approximately 0.05). The correlation for the ejection fraction was acceptable (r = 0.60) without a statistically significant difference (p = 0.37) and the Bland Altman plot range was narrow (25.8%). There was a satisfactory correlation of the US' shortening fraction with CMR's ejection fraction (r = 0.58).
  
  
  CONCLUSIONS
  In cases where cardiac wall movement abnormalities are absent, the US Teichholz's M-mode formula for volume measurements, though less sophisticated in comparison to the high resolution CMR technique, offers an adequate ejection fraction estimation for routine use, especially when monitoring gross alterations in cardiac function over time, and is easy to perform.
authors.affiliation: First Department of Internal Medicine of Laiko General Hospital, University of Athens, Athens, Greece. giakanas@otenet.gr
authors.forename: Anastasios
authors.initials: A
authors.lastname: Giakoumis
authors.forename: Vasilis
authors.initials: V
authors.lastname: Berdoukas
authors.forename: Efstathios
authors.initials: E
authors.lastname: Gotsis
authors.forename: Athanassios
authors.initials: A
authors.lastname: Aessopos
mesh_terms: D000328:Adult; D001803:Blood Transfusion; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control*; D017086:beta-Thalassemia / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*