Two-dimensional speckle strain for evaluation of left ventricular systolic deformation in children with thalassemia major

Abstract EN

Background: In Is-thalassemia major, identifying early myocardial insult is important. Aims : the aim of this study was to clarify the value of 2 D-strain (2DS) in early detection of segmental and global left ventricular systolic dysfunction in thalassemia children. Methods : this study included two age-matched groups : Group 1 (n=30) children with Beta thalassemia and Group 2 (n=30) healthy control subjects.

They underwent conventional echo-Doppler measures of left ventricular (LV) systolic and diastolic functions and pulsed wave tissue Doppler of lateral mitral annulus.

Longitudinal 2D strain in 18 left ventricular segments using 2 dimensional (2DS) speckle-tracking imaging from apical 4, 2, and apical long axis views, using a Vivid 7ultrasound system was recorded. Results : left ventricular systolic and diastolic functions were similar in both groups in conventional and pulsed tissue Doppler studies.

However, on using 2 D strain images there were significant multi-segmental deformations of different walls of the LV in the thalassemia group.

Peak global LV systolic strain was significantly affected compared to control group (17.613.04% vs! -19.6 ± 1.65% P = 0.004).

There was no significant correlation between global LV systolic strains and serum ferritin levels. Conclusion : thalassemia children have segmental and global systolic myocardial dysfunctions in the left ventricular walls and 2DS seems a promising new tool for early detection of segmental and global cardiac insult in these patients.