Tissue Doppler echocardiography reliably reflects severity of iron overload in pediatric patients with beta thalassemia.
OBJECTIVE
Tissue Doppler imaging has been recently used to evaluate ventricular function in patients with beta thalassemia. In clinical practice, serum ferritin is commonly used to assess the severity of iron overload. The aim of this study was to determine which Doppler findings correlated with serum ferritin.


RESULTS
Thirty-one pediatric patients with transfusion-dependent beta thalassemia with normal LVFS were evaluated. Seven patients with serum ferritin <2500 ng/ mL, 13 patients with serum ferritin 2500-5000 ng/mL, and 11 patients with serum ferritin >5000 ng/mL were studied. Diastolic dysfunction was absent in all patients with serum ferritin <2500 ng/mL, and was present in all patients with serum ferritin >5000 ng/mL. Deceleration time (DT) has a significant correlation with serum ferritin (r = -0.59, p < 0.0001). Difference of pulmonary vein atrial reversal flow and mitral valve A wave duration (PVAR - MVA) and early ventricular filling velocity to early diastolic myocardial velocity ratio (E/Em) significantly correlated with serum ferritin (r = 0.49, p = 0.006; r = 0.56, p = 0.001, respectively).


CONCLUSIONS
Decreased DT, increased PVAR-MVA duration, and increased E/Em ratio reliably reflected severe iron overload in pediatric patients with beta thalassemia. Systolic and diastolic LV function is preserved in patients who have serum ferritin <2500 ng/mL.
Silvilairat
Suchaya
S
Division of Pediatric Cardiology, Chiang Mai University, Chiang Mai, Thailand. ssamana@mail.med.cmu.ac.th
Sittiwangkul
Rekwan
R
Pongprot
Yupada
Y
Charoenkwan
Pimlak
P
Phornphutkul
Charlie
C
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015150:Echocardiography, Doppler; D005260:Female; D005293:Ferritins / Q000097:blood; D006801:Humans; D019190:Iron Overload / Q000097:blood / Q000000981:diagnostic imaging* / Q000209:etiology; D008297:Male; D012189:Retrospective Studies; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000000981:diagnostic imaging* / Q000209:etiology; D017086:beta-Thalassemia / Q000097:blood* / Q000150:complications
D005293:Ferritins