E-ISSN: 1305-3612
    Relationship between color M-mode echocardiography flow propagation and cardiac iron load on MRI in patients with thalassemia major
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    Cardiovascular Imaging - Original Article
    VOLUME: 18 ISSUE: 2
    P: 208-214
    March 2012

    Relationship between color M-mode echocardiography flow propagation and cardiac iron load on MRI in patients with thalassemia major

    Diagn Interv Radiol 2012;18(2):208-214
    DOI: 10.4261/1305-3825.DIR.4581-11.1
    Orhan Özbek 1
    Kadir Acar 2
    Mehmet Kayrak 3
    Seda Özbek 4
    Enes Elvin Gül 5
    Ramazan Uçar 5
    Yahya Paksoy 6
    1. Department of Radiology, Necmettin Erbakan University, Meram Faculty of Medicine, Konya, Turkey
    2. Department of Hematology, Gazi University Faculty of Medicine, Ankara, Turkey
    3. Departments of Radiology, Selçuk University Meram School of Medicine, Meram, Konya, Turkey
    4. Department of Radiology, Selcuk University Faculty of Medicine, Konya, Turkey
    5. Departments of Hematology, Selçuk University Meram School of Medicine, Meram, Konya, Turkey
    6. Departments of Radiology Selçuk University School of Medicine, Konya, Turkey.
    No information available.
    No information available
    Received Date: 11.05.2011
    Accepted Date: 30.06.2011
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    ABSTRACT

    PURPOSE

    Myocardial iron overload remains an important problem and results in cardiac dysfunction in patients with thalassemia major (TM). The ratio of color M-mode flow propagation velocity to early diastolic transmitral flow velocity (E/Vp) in echocardiography is a marker of increased left ventricular filling pressure, which is independent of preload, afterload, and heart rate. We examined the relationship between E/Vp and iron loading in patients with TM using cardiac magnetic resonance imaging (MRI).

    MATERIALS AND METHODS

    Twenty-one TM patients and 21 age-matched healthy controls were enrolled in the study. Transmitral flow, pulmonary vein velocities, and Vp were obtained by two blinded echocardiographers. Left ventricular isovolumetric relaxation time (IVRT) was measured in the apical long axis by echocardiography. All patients also underwent MRI for cardiac T2* evaluation of iron overload. An increased E/Vp was defined as >1.5.

    RESULTS

    The E/Vp ratio was increased in TM patients compared with control subjects (1.7±0.4 and 1.2±0.2, P < 0.01, respectively). There was no correlation between E/Vp and cardiac T2* value. E/Vp was significantly correlated with IVRT (r=0.51, P = 0.02). In addition, the cardiac T2* value was comparable in patients with an E/Vp >1.5 and E/Vp ≤1.5 (21.1±9.8 ms vs. 22.3±8.0 ms, P = 0.80, respectively).

    CONCLUSION

    E/Vp may be a marker of diastolic abnormality that is independent from myocardial iron load in TM patients with preserved left ventricular function.

    Keywords: thalassemia major, iron overload, magnetic resonance imaging, Doppler echocardiography

    References

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