Amoozgar Hamid, Farhani Nahal, Karimi Mehran
Division of Pediatric Cardiology, Department of Pediatrics, Nemazee Hospital, Shiraz University of Medical Sciences, 7193711351, Shiraz, Iran.
Pediatr Cardiol. 2011 Feb;32(2):154-9. doi: 10.1007/s00246-010-9834-2. Epub 2010 Nov 17.
Heart complications are among the serious problems of patients with β-thalassemia intermedia. This study aimed to evaluate myocardial function in these patients. Clinical parameters and both standard Doppler and pulsed Doppler tissue imaging parameters were compared in 51 β-thalassemia intermedia patients (mean age, 17.05 ± 5.8 years) and 20 normal subjects (mean age, 17.81 ± 7.35 years, p = 0.98). In 11 patients (21.5%), pulmonary artery hypertension was detected. M-mode echocardiographic findings such as ejection fraction and fractional shortening did not show statistically significant changes (p > 0.005). Pulsed Doppler showed a significant difference in the early (E) to late diastolic (A) velocity ratio of the tricuspid and mitral valve between the patients and the control subjects (p < 0.05). In the pulsed tissue Doppler study, the peak systolic velocity of the septum (Ss), the peak atrial velocity of the septum (Aas), the peak systolic velocity of the tricuspid annulus (St), the peak early diastolic velocity of the tricuspid annulus (Eat), and the peak late diastolic velocity of the tricuspid annulus (Aat) were increased significantly (p < 0.05). The pulse tissue Doppler of the lateral mitral annulus did not change significantly (p > 0.005). The peak systolic velocity of the posterior wall and the peak late diastolic velocity of the anterior wall changed significantly (p < 0.05). This study showed that β-thalassemia intermedia patients with normal M-mode and two-dimensional echocardiography had statistically significant changes in pulsed Doppler and pulsed tissue Doppler imaging.
心脏并发症是中间型β地中海贫血患者面临的严重问题之一。本研究旨在评估这些患者的心肌功能。对51例中间型β地中海贫血患者(平均年龄17.05±5.8岁)和20名正常受试者(平均年龄17.81±7.35岁,p=0.98)的临床参数以及标准多普勒和脉冲多普勒组织成像参数进行了比较。在11例患者(21.5%)中检测到肺动脉高压。M型超声心动图检查结果如射血分数和缩短分数未显示出统计学上的显著变化(p>0.005)。脉冲多普勒显示,患者与对照受试者之间三尖瓣和二尖瓣舒张早期(E)与舒张晚期(A)速度比值存在显著差异(p<0.05)。在脉冲组织多普勒研究中,室间隔的峰值收缩速度(Ss)、室间隔的峰值心房速度(Aas)、三尖瓣环的峰值收缩速度(St)、三尖瓣环的舒张早期峰值速度(Eat)和三尖瓣环的舒张晚期峰值速度(Aat)均显著增加(p<0.05)。二尖瓣外侧环的脉冲组织多普勒无显著变化(p>0.005)。后壁的峰值收缩速度和前壁的舒张晚期峰值速度有显著变化(p<0.05)。本研究表明,M型和二维超声心动图正常的中间型β地中海贫血患者在脉冲多普勒和脉冲组织多普勒成像方面有统计学上的显著变化。