title: Assessment of left ventricular functions and myocardial iron load with tissue Doppler and speckle tracking echocardiography and T2* MRI in patients with β-thalassemia major.
abstract: BACKGROUND
  The purpose of this study is to determine early myocardial dysfunction in β-thalassemia major (BTM) patients. Where the myocardial dysfunction cannot be detected by conventional echocardiography, it could be detected by tissue Doppler imaging (TDI) or speckle tracking echocardiography (STE).
  
  
  METHODS
  In this study, we analyzed 60 individuals, 30 of whom were BTM patients and the other 30 of whom were the control group. T2* magnetic resonance imaging (MRI) was used to measure cardiac iron deposition. The myocardial functions were evaluated by conventional echocardiography, TDI and STE.
  
  
  RESULTS
  When basal lateral left ventricular and basal septal wall TDI values were compared between the patient group and control group, only isovolumic contraction time values were significantly longer in the patients. The global circumferential strain was significantly lower in the patients. When evaluated as segmental, longitudinal strain values of basal inferoseptum and circumferential strain values of anteroseptum, anterior, and inferolateral segments were significantly lower in the patients. In the patients, global longitudinal and circumferential strains in the group who had pathological T2* values were significantly lower than the group who did not. In addition, circumferential strain values in anteroseptum, anterolateral, inferior, and inferoseptum segments were significantly lower in the patients with T2* values<20 ms than those with T2* values≥20 ms.
  
  
  CONCLUSIONS
  Although T2* MRI is the most sensitive test detecting myocardial iron load, TDI and STE can be used for screening myocardial dysfunction. The abnormal strain values, especially circumferential, may be detected as the first finding of abnormal iron load and related to T2* values.
authors.affiliation: Department of Pediatric Cardiology, Ankara Children's Hematology and Oncology Research and Training Hospital, Ankara, Turkey.
authors.forename: Mehmet Emre
authors.identifier: http://orcid.org/0000-0001-7932-1074
authors.initials: ME
authors.lastname: Ari
authors.affiliation: Department of Pediatric Cardiology, Ankara Children's Hematology and Oncology Research and Training Hospital, Ankara, Turkey.
authors.forename: Filiz
authors.initials: F
authors.lastname: Ekici
authors.affiliation: Department of Pediatric Cardiology, Ankara Children's Hematology and Oncology Research and Training Hospital, Ankara, Turkey.
authors.forename: İbrahim İlker
authors.initials: İİ
authors.lastname: Çetin
authors.affiliation: Department of Pediatric Hematology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Emine Betül
authors.initials: EB
authors.lastname: Tavil
authors.affiliation: Department of Pediatric Hematology, Ankara Children's Hematology and Oncology Research and Training Hospital, Ankara, Turkey.
authors.forename: Neşe
authors.initials: N
authors.lastname: Yaralı
authors.affiliation: Department of Pediatric Hematology, Ankara Children's Hematology and Oncology Research and Training Hospital, Ankara, Turkey.
authors.forename: Pamir
authors.initials: P
authors.lastname: Işık
authors.affiliation: Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Tuncay
authors.initials: T
authors.lastname: Hazırolan
authors.affiliation: Department of Pediatric Hematology, Ankara Children's Hematology and Oncology Research and Training Hospital, Ankara, Turkey.
authors.forename: Bahattin
authors.initials: B
authors.lastname: Tunç
mesh_terms: D000293:Adolescent; D004452:Echocardiography / Q000379:methods*; D015150:Echocardiography, Doppler; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D019190:Iron Overload / Q000097:blood / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D015203:Reproducibility of Results; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000000981:diagnostic imaging*; D017086:beta-Thalassemia / Q000097:blood / Q000150:complications*
keywords: cardiac magnetic resonance imaging; left ventricular function; strain; tissue Doppler imaging