AN SPECKLE TRACKING IMAGING REVEAL MYOCARDIAL IRON OVERLOAD IN THALASSEMIAMAJOR? A COMBINED ECHOCARDIOGRAPHY AND CARDIAC MAGNETIC RESONANCE STUDY
(Abstract release date: 05/19/16)
EHA Library. Meloni A. 06/09/16; 133040; E1491
Dr. Antonella Meloni
Contributions
Contributions
Abstract
Abstract: E1491
Type: Eposter Presentation
Background
Cardiac complications related to myocardial iron overload (MIO) remain the main cause of morbidity and mortality in thalassemia major (TM). Cardiac magnetic resonance (CMR) is a unique non-invasive technique to quantify MIO and the multislice T2* technique allows the identification of different patterns of MIO. Unfortunately, the availability for CMR scans in validated centers is still limited in many countries. On the other hand, echocardiography is a widely diffused, non-expensive and feasible technique, with elevated accuracy in the evaluation of cardiac function and morphology. Nevertheless, standard echocardiographic examination fails in detecting MIO until a substantial reduction of the left ventricular ejection fraction (LVEF) occurs. The evaluation of myocardial deformation by two-dimensional speckle tracking imaging (2DSTI) demonstrated a great accuracy in detecting subtle myocardial dysfunction in many different pathologic conditions.
Aims
We aimed to investigate the role of 2DSTI in the detection of MIO in patients affected by TM, comparing the data of myocardial deformation with T2* values derived by CMR.
Methods
We recruited 31 TM patients [15 males (48,4%); mean age: 37.87±9.64 years] consecutively enrolled in the Myocardial Iron Overload in Thalassemia (MIOT) Network. All patients underwent to CMR and to echocardiography in the same day.CMR was performed with a 1.5-T scanner and segmental and global T2* values were measured with a previously validated software (HIPPO MIOT®).Values of GLS were derived from the three apical views, while radial and circumferential strain were obtained from the three parasternal short axis views. All the echocardiographic examinations were performed with a commercial ultrasound system (Mylab-alpha, Esaote) equipped with a 1-4 Mhz phased array probe.
Results
Mean global heart T2* was 35.91±12.69 ms (range:5.63-47.13 ms). Six patients (19.4%) showed pathologic T2* values (<20 ms) indicative of MIO. GLS showed a significant correlation with T2* values (R=-0.401; P=0.025), moreover, the percentage of patients with altered GLS (lower or equal -19) was significantly higher in the group with a significant MIO than in the group with no significant MIO (global heart T2* ≥ 20 ms) (83% vs 28%, P<0.05). Logistic regression demonstrated that patients with impaired GLS had a significant higher risk of showing pathological T2* values (Odds-ratio-OR=12.86, 95%CI=1.27-130.54; P=0.031).No relation was observed between GLS, age and sex, and between T2* values, LVEF, radial strain and circumferential strain.
Conclusion
Left ventricular GLS can be useful in detecting subtle myocardial dysfunction due to MIO in TM patients, demonstrating a significant correlation with MIO detected by CMR.
Session topic: E-poster
Keyword(s): Magnetic resonance imaging, Thalassemia
Type: Eposter Presentation
Background
Cardiac complications related to myocardial iron overload (MIO) remain the main cause of morbidity and mortality in thalassemia major (TM). Cardiac magnetic resonance (CMR) is a unique non-invasive technique to quantify MIO and the multislice T2* technique allows the identification of different patterns of MIO. Unfortunately, the availability for CMR scans in validated centers is still limited in many countries. On the other hand, echocardiography is a widely diffused, non-expensive and feasible technique, with elevated accuracy in the evaluation of cardiac function and morphology. Nevertheless, standard echocardiographic examination fails in detecting MIO until a substantial reduction of the left ventricular ejection fraction (LVEF) occurs. The evaluation of myocardial deformation by two-dimensional speckle tracking imaging (2DSTI) demonstrated a great accuracy in detecting subtle myocardial dysfunction in many different pathologic conditions.
Aims
We aimed to investigate the role of 2DSTI in the detection of MIO in patients affected by TM, comparing the data of myocardial deformation with T2* values derived by CMR.
Methods
We recruited 31 TM patients [15 males (48,4%); mean age: 37.87±9.64 years] consecutively enrolled in the Myocardial Iron Overload in Thalassemia (MIOT) Network. All patients underwent to CMR and to echocardiography in the same day.CMR was performed with a 1.5-T scanner and segmental and global T2* values were measured with a previously validated software (HIPPO MIOT®).Values of GLS were derived from the three apical views, while radial and circumferential strain were obtained from the three parasternal short axis views. All the echocardiographic examinations were performed with a commercial ultrasound system (Mylab-alpha, Esaote) equipped with a 1-4 Mhz phased array probe.
Results
Mean global heart T2* was 35.91±12.69 ms (range:5.63-47.13 ms). Six patients (19.4%) showed pathologic T2* values (<20 ms) indicative of MIO. GLS showed a significant correlation with T2* values (R=-0.401; P=0.025), moreover, the percentage of patients with altered GLS (lower or equal -19) was significantly higher in the group with a significant MIO than in the group with no significant MIO (global heart T2* ≥ 20 ms) (83% vs 28%, P<0.05). Logistic regression demonstrated that patients with impaired GLS had a significant higher risk of showing pathological T2* values (Odds-ratio-OR=12.86, 95%CI=1.27-130.54; P=0.031).No relation was observed between GLS, age and sex, and between T2* values, LVEF, radial strain and circumferential strain.
Conclusion
Left ventricular GLS can be useful in detecting subtle myocardial dysfunction due to MIO in TM patients, demonstrating a significant correlation with MIO detected by CMR.
Session topic: E-poster
Keyword(s): Magnetic resonance imaging, Thalassemia
Abstract: E1491
Type: Eposter Presentation
Background
Cardiac complications related to myocardial iron overload (MIO) remain the main cause of morbidity and mortality in thalassemia major (TM). Cardiac magnetic resonance (CMR) is a unique non-invasive technique to quantify MIO and the multislice T2* technique allows the identification of different patterns of MIO. Unfortunately, the availability for CMR scans in validated centers is still limited in many countries. On the other hand, echocardiography is a widely diffused, non-expensive and feasible technique, with elevated accuracy in the evaluation of cardiac function and morphology. Nevertheless, standard echocardiographic examination fails in detecting MIO until a substantial reduction of the left ventricular ejection fraction (LVEF) occurs. The evaluation of myocardial deformation by two-dimensional speckle tracking imaging (2DSTI) demonstrated a great accuracy in detecting subtle myocardial dysfunction in many different pathologic conditions.
Aims
We aimed to investigate the role of 2DSTI in the detection of MIO in patients affected by TM, comparing the data of myocardial deformation with T2* values derived by CMR.
Methods
We recruited 31 TM patients [15 males (48,4%); mean age: 37.87±9.64 years] consecutively enrolled in the Myocardial Iron Overload in Thalassemia (MIOT) Network. All patients underwent to CMR and to echocardiography in the same day.CMR was performed with a 1.5-T scanner and segmental and global T2* values were measured with a previously validated software (HIPPO MIOT®).Values of GLS were derived from the three apical views, while radial and circumferential strain were obtained from the three parasternal short axis views. All the echocardiographic examinations were performed with a commercial ultrasound system (Mylab-alpha, Esaote) equipped with a 1-4 Mhz phased array probe.
Results
Mean global heart T2* was 35.91±12.69 ms (range:5.63-47.13 ms). Six patients (19.4%) showed pathologic T2* values (<20 ms) indicative of MIO. GLS showed a significant correlation with T2* values (R=-0.401; P=0.025), moreover, the percentage of patients with altered GLS (lower or equal -19) was significantly higher in the group with a significant MIO than in the group with no significant MIO (global heart T2* ≥ 20 ms) (83% vs 28%, P<0.05). Logistic regression demonstrated that patients with impaired GLS had a significant higher risk of showing pathological T2* values (Odds-ratio-OR=12.86, 95%CI=1.27-130.54; P=0.031).No relation was observed between GLS, age and sex, and between T2* values, LVEF, radial strain and circumferential strain.
Conclusion
Left ventricular GLS can be useful in detecting subtle myocardial dysfunction due to MIO in TM patients, demonstrating a significant correlation with MIO detected by CMR.
Session topic: E-poster
Keyword(s): Magnetic resonance imaging, Thalassemia
Type: Eposter Presentation
Background
Cardiac complications related to myocardial iron overload (MIO) remain the main cause of morbidity and mortality in thalassemia major (TM). Cardiac magnetic resonance (CMR) is a unique non-invasive technique to quantify MIO and the multislice T2* technique allows the identification of different patterns of MIO. Unfortunately, the availability for CMR scans in validated centers is still limited in many countries. On the other hand, echocardiography is a widely diffused, non-expensive and feasible technique, with elevated accuracy in the evaluation of cardiac function and morphology. Nevertheless, standard echocardiographic examination fails in detecting MIO until a substantial reduction of the left ventricular ejection fraction (LVEF) occurs. The evaluation of myocardial deformation by two-dimensional speckle tracking imaging (2DSTI) demonstrated a great accuracy in detecting subtle myocardial dysfunction in many different pathologic conditions.
Aims
We aimed to investigate the role of 2DSTI in the detection of MIO in patients affected by TM, comparing the data of myocardial deformation with T2* values derived by CMR.
Methods
We recruited 31 TM patients [15 males (48,4%); mean age: 37.87±9.64 years] consecutively enrolled in the Myocardial Iron Overload in Thalassemia (MIOT) Network. All patients underwent to CMR and to echocardiography in the same day.CMR was performed with a 1.5-T scanner and segmental and global T2* values were measured with a previously validated software (HIPPO MIOT®).Values of GLS were derived from the three apical views, while radial and circumferential strain were obtained from the three parasternal short axis views. All the echocardiographic examinations were performed with a commercial ultrasound system (Mylab-alpha, Esaote) equipped with a 1-4 Mhz phased array probe.
Results
Mean global heart T2* was 35.91±12.69 ms (range:5.63-47.13 ms). Six patients (19.4%) showed pathologic T2* values (<20 ms) indicative of MIO. GLS showed a significant correlation with T2* values (R=-0.401; P=0.025), moreover, the percentage of patients with altered GLS (lower or equal -19) was significantly higher in the group with a significant MIO than in the group with no significant MIO (global heart T2* ≥ 20 ms) (83% vs 28%, P<0.05). Logistic regression demonstrated that patients with impaired GLS had a significant higher risk of showing pathological T2* values (Odds-ratio-OR=12.86, 95%CI=1.27-130.54; P=0.031).No relation was observed between GLS, age and sex, and between T2* values, LVEF, radial strain and circumferential strain.
Conclusion
Left ventricular GLS can be useful in detecting subtle myocardial dysfunction due to MIO in TM patients, demonstrating a significant correlation with MIO detected by CMR.
Session topic: E-poster
Keyword(s): Magnetic resonance imaging, Thalassemia
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