title: Comparison of tissue Doppler imaging with MRI t2* and 24-hour rhythm holter heart rate variability for diagnosing early cardiac impairment in thalassemia major patients.
abstract: OBJECTIVE
  Cardiology follow up is important in thalassemia major patients. The object of this study is to define parameters which can be used in the early detection of cardiac impairment.
  
  
  METHODS
  Forty seven beta thalassemia major patients (mean age 16.3 ± 4.47 years; 22 boys, 25 girls) whose left ventricular systolic functions were normal and a healthy control group of fifty age and gender matched children were included in the study. M-mode echocardiographic measurements, systolic and diastolic functions with PW and tissue Doppler and heart rate variabilities (HRVs) were compared between the two groups. The patients were also grouped according to MRT2*, ferritin and left ventricular diastolic diameters (LVDds) to compare the echocardiographic and Holter parameters among them.
  
  
  RESULTS
  None of the children in the study group had symptomatic congestive heart failure. PW Doppler late diastolic forward flow in pulmonary artery was higher in the thalassemia group when compared with the control group (P = 0.01) indicating decreased compliance of the right ventricle. While the systolic and diastolic functions were normal, all the HRV parameters in the thalassemia group were significantly lower than the control group (P = 0.005).
  
  
  CONCLUSIONS
  Significant decrease in HRV and increase in PW late diastolic forward flow in pulmonary artery in the absence of systolic or diastolic dysfunction, points out that these parameters can be useful in detection of early cardiac impairment.
authors.affiliation: 1Department of Pediatrics, Istanbul Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ayse Filiz
authors.initials: AF
authors.lastname: Yetimakman
authors.forename: Kazim
authors.initials: K
authors.lastname: Oztarhan
authors.forename: Gonul
authors.initials: G
authors.lastname: Aydogan
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D005293:Ferritins / Q000097:blood; D006331:Heart Diseases / Q000175:diagnosis*; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D017086:beta-Thalassemia / Q000150:complications* / Q000503:physiopathology
chemical_list: D005293:Ferritins
keywords: cardiology; iron overload; pediatric cardiology; thalassemia