title: Serial echocardiographic left ventricular ejection fraction measurements: a tool for detecting thalassemia major patients at risk of cardiac death.
abstract: Cardiac damage remains a major cause of mortality among patients with thalassemia major. The detection of a lower cardiac magnetic resonance T2* (CMR-T2*) signal has been suggested as a powerful predictor of the subsequent development of heart failure. However, the lack of worldwide availability of CMR-T2* facilities prevents its widespread use for follow-up evaluations of cardiac function in thalassemia major patients, warranting the need to assess the utility of other possible procedures. In this setting, the determination of left ventricular ejection fraction (LVEF) offers an accurate and reproducible method for heart function evaluation. These findings suggest a reduction in LVEF≥7%, over time, determined by 2-D echocardiography, may be considered a strong predictive tool for the detection of thalassemia major patients with increased risk of cardiac death. The reduction of LVEF≥7% had higher (84.76%) predictive value. Finally, Kaplan-Meier survival curves of thalassemia major patients with LVEF≥7% showed a statistically significant decreased probability of survival for heart disease (p=0.0022). However, because of limitations related to the study design, such findings should be confirmed in a large long-term prospective clinical trial.
authors: U.O.C. Ematologia II, AOR Villa Sofia-V. Cervello, Palermo, Italy. aurelio.maggio@ospedaliriunitipalermo.it
authors: Aurelio
authors: A
authors: Maggio
authors: Angela
authors: A
authors: Vitrano
authors: Giuseppina
authors: G
authors: Calvaruso
authors: Rita
authors: R
authors: Barone
authors: Paolo
authors: P
authors: Rigano
authors: Luigi
authors: L
authors: Mancuso
authors: Liana
authors: L
authors: Cuccia
authors: Marcello
authors: M
authors: Capra
authors: Lorella
authors: L
authors: Pitrolo
authors: Luciano
authors: L
authors: Prossomariti
authors: Aldo
authors: A
authors: Filosa
authors: Vincenzo
authors: V
authors: Caruso
authors: Calogera
authors: C
authors: Gerardi
authors: Saveria
authors: S
authors: Campisi
authors: Paolo
authors: P
authors: Cianciulli
authors: Androulla
authors: A
authors: Elefteriou
authors: Michel
authors: M
authors: Angastiniotis
authors: Hala
authors: H
authors: Hamza
authors: Paul
authors: P
authors: Telfer
authors: John Malcolm
authors: JM
authors: Walker
authors: Arintaya
authors: A
authors: Phrommintikul
authors: Nipon
authors: N
authors: Chattipakorn
mesh_terms: D000328:Adult; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D015233:Models, Statistical; D012372:ROC Curve; D013318:Stroke Volume; D055815:Young Adult; D017086:beta-Thalassemia / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology