title: Diagnostic value of electrocardiography compared with echocardiography in measuring left ventricular mass index in major thalassemia patients over 10 years of age.
abstract: BACKGROUND
  Patients suffering from major beta thalassemia need frequent blood transfusions and, if not treated well, would be at risk of heart dysfunction. This study was performed to determine the diagnostic value of electrocardiography versus echocardiography in measuring the left ventricular mass index in these patients.
  
  
  METHODS
  Between July 2010 and June 2011, 82 asymptomatic patients over 10 years of age with major thalassemia (42 men with a mean age of 17.65 ± 3.39 years and 40 women with a mean age of 16.9 ± 3.38 years) were enrolled in this study. For all the patients, standard electrocardiography (to measure R in aVL and S in V3 and calculate left ventricular mass index by electrocardiography) and echocardiography (to measure interventricular septum diameter in diastole, left ventricular posterior wall diameter in diastole, and left ventricular diameter in diastole in order to calculate left ventricular mass index by echocardiography) were performed, at least one week after transfusion. The calculated left ventricular mass indices were thereafter compared between the two methods (electrocardiography and echocardiography).
  
  
  RESULTS
  Sensitivity, specificity, positive predictive value, and negative predictive value in the two techniques in determining the left ventricular mass index were 67%, 25%, 89%, and 7% in the females, 65%, 33%, 92%, and 6% in the males, and 67%, 14%, 89%, and 3% in the total population, respectively. Furthermore, this study demonstrated that the average left ventricular mass index by echocardiography and electrocardiography was 104.86 ± 21.65 gr/m2 and 91.69 ± 12.03 gr/m2, respectively. Echocardiography was much more accurate than electrocardiography in determining the left ventricular mass index (p value = 0.0001).
  
  
  CONCLUSIONS
  The findings of this study demonstrated that echocardiography was more accurate and more reliable than electrocardiography in determining the left ventricular mass index in major thalassemia patients.
authors.affiliation: Children and Adolescent Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
authors.forename: Noormohammad
authors.initials: N
authors.lastname: Noori
authors.affiliation: Children and Adolescent Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
authors.forename: Maziar
authors.initials: M
authors.lastname: Mahjoubifard
authors.affiliation: Rajaei Cardiovascular, Medical and Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Seyed Mostafa
authors.initials: SM
authors.lastname: Alavi
authors.affiliation: Rajaei Cardiovascular, Medical and Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Saeid
authors.initials: S
authors.lastname: Hosseini
authors.affiliation: Rajaei Cardiovascular, Medical and Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Sanati
authors.affiliation: Rajaei Cardiovascular, Medical and Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Yalda
authors.initials: Y
authors.lastname: Mirmesdagh
keywords: Echocardiography; Electrocardiography; Thalassemia