Batouty Nihal M, Tawfik Ahmad M, Sobh Donia M, Gadelhak Basma N, El-Ashwah Shimaa, Hussein Mohamed Abdelghafar, Gad Mai, Aziz A Ashraf Abd El, El-Shahed Mahmoud Abd, Karam Rasha
Department of Diagnostic Radiology, Faculty of Medicine, Mansoura University, Elgomhoria St., Mansoura, 35516, Egypt.
Department of Hematology, Faculty of Medicine, Mansoura University, Elgomhoria St., Mansoura, 35516, Egypt.
J Cardiovasc Imaging. 2024 Aug 3;32(1):18. doi: 10.1186/s44348-024-00026-1.
Cardiac magnetic resonance imaging (CMR) is the modality of choice for quantification of myocardial iron overload in β-thalassemia major patients using the T2* sequence. CMR feature tracking (FT) is a recent magnetic resonance imaging tool that gives an idea about myocardial fibers deformation; thus, it can detect early impairment in myocardial function even before the reduction in ejection fraction.
This study aims to assess the ability of left ventricular CMR-FT in the early detection of systolic dysfunction in β thalassemia major patients and to correlate it with the degree of myocardial iron overload measured by CMR T2*. This prospective study enrolled 57 β thalassemia major patients who received long-term blood transfusion and 20 healthy controls. CMR was used to evaluate left ventricular volumes, ejection fraction, and the amount of myocardial T2*. A two-dimensional left ventricular FT analysis was performed. Both global and segmental left ventricular strain values were obtained.
The mean global circumferential strain (GCS) and global radial strain (GRS) values were significantly lower in patients compared to control (P = 0.002 and P = 0.006, respectively). No correlation was found between T2* values and ejection fraction; however, there was a significant correlation between T2* values and GCS and GRS (P = 0.012 and P = 0.025, respectively) in thalassemia patients. Regional strain revealed significantly lower values of GCS and GRS in basal regions compared to apical ones (P = 0.000).
Our study revealed that CMR-FT can play a role in the early detection of systolic impairment in thalassemia patients.
心脏磁共振成像（CMR）是使用T2*序列对重型β地中海贫血患者心肌铁过载进行定量分析的首选方式。CMR特征追踪（FT）是一种最新的磁共振成像工具，可了解心肌纤维变形情况；因此，它甚至能在射血分数降低之前检测到心肌功能的早期损害。
本研究旨在评估左心室CMR-FT在早期检测重型β地中海贫血患者收缩功能障碍方面的能力，并将其与通过CMR T2测量的心肌铁过载程度相关联。这项前瞻性研究纳入了57例接受长期输血的重型β地中海贫血患者和20名健康对照者。使用CMR评估左心室容积、射血分数和心肌T2含量。进行二维左心室FT分析，获取左心室整体和节段应变值。
与对照组相比，患者的平均整体圆周应变（GCS）和整体径向应变（GRS）值显著更低（分别为P = 0.002和P = 0.006）。未发现T2值与射血分数之间存在相关性；然而，在地中海贫血患者中，T2值与GCS和GRS之间存在显著相关性（分别为P = 0.012和P = 0.025）。区域应变显示，与心尖区域相比，基底区域的GCS和GRS值显著更低（P = 0.000）。
我们的研究表明，CMR-FT可在早期检测地中海贫血患者的收缩功能损害中发挥作用。
