Usefulness of Pulsed Wave Tissue Doppler Imaging in Assessment of Left Ventricular Functions in Children with Beta-Thalassemia Major

To evaluate the changes in the LV systolic and diastolic function in children with beta-thalassemia major (beta-TM) using pulsed wave tissue doppler (TD) echocardiography. Clinical, conventional echo doppler and pulsed wave tissue doppler imaging parameters were compared in 40 beta-thalassemia major patients (mean age, 6.52 +/- 3.5 y) and 25 age and sex matched normal subjects (mean age, 6.5 +/- 2.7 y). There were no significant statistical differences between mean fractional shortening (FS) and ejection fraction (EF) of left ventricle (LV) of the patients and control group. Children with beta-thalassemia had significantly lower E' wave velocities measured at the left ventricular septal annulus (8.1 +/- 3.3 vs. 13 +/- 2.5, P < 0.001), lateral margin of the mitral annulus (9.1 +/- 5.4 vs. 13.3 +/- 2.5, P < 0.001) and lateral margin of the tricuspid annulus (9.3 +/- 3.9 vs. 13.3 +/- 2.5, P < 0.001) when compared to the control group. Furthermore children with beta-thalassemia had significantly lower E'/A' wave ratio at the left ventricular septal annulus (0.76 +/- 0.34 vs. 1.36 +/- 0.23), lateral margin of the mitral annulus (0.83 +/- 0.17 vs. 1.28 +/- 0.22), and lateral margin of the tricuspid annulus ((0.90 +/- 0.27 vs. 1.26 +/- 0.23, (P < 0.05) when compared to the control group. This study showed that patients with beta-thalassemia major and normal conventional echo doppler parameters had statistically significant changes detected by pulsed wave tissue doppler imaging.