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Systolic and diastolic function in middle aged patients with sickle ß thalassaemia. An echocardiographic study

¹ Cardiology Department, Laiko General Hospital, Athens, Greece
² First Department of Internal Medicine, University of Athens Medical School, Laiko General Hospital
³ Thalassemia Department, Laiko General Hospital

Correspondence to:
Correspondence to:
Dr D P Papadopoulos
Laiko General Hospital of Athens, Department of Cardiology, 6–8 Glykonos Street St-10675, Athens, Greece; jimpapdoc{at}yahoo.com

Objective: To evaluate the right and left ventricular systolic and diastolic function in middle aged patients with sickle ß thalassaemia.

Methods: Forty three patients with sickle ß thalassaemia were recruited for echocardiographic study while 55 controls, matched for age and sex, served as the control group. Parameters measured included: dimensions and wall thickness of left (LV) and right (RV) ventricle and left atrium, LV mass, and cardiac index. LV and RV contractility variables—ejection fraction, circumferential fibre shortening velocity, end systolic stress, end systolic stress/volume index ratio, mitral and tricuspid annulus systolic excursion, and Tei index—were also calculated. The study also evaluated parameters of RV and LV diastolic function including early and late atrioventricular flow velocities (E and A wave respectively), E/A ratio, deceleration time (DT), isovolumic relaxation time (IVRT) as well as pulmonary and hepatic veins systolic to diastolic (S/D) ratio.

Results: Chamber enlargement, greater LV mass index, cardiac index, and RV wall thickness were found in the anaemic group compared with controls. The LV and RV contractility variables of the patients were similar to controls. Conversely the LV and RV Tei index was significantly greater in the patient group. Diastolic dysfunction was present in the anaemic patients resulting from the increased LV and RV A-wave, the longer LVIVRT, RVIVRT, and RVDT, as well as the higher hepatic and pulmonary veins S/D ratio.

Conclusions: The results show that in middle aged patients with sickle ß thalassaemia the diastolic function is abnormal in both ventricles but still more in RV, whereas the systolic function remains unchanged.

Abbreviations: RV, right ventricle; LV, left ventricle; DT, deceleration time; FS, fractional shortening; EF, ejection fraction; TAPSE, tricuspid annular plane systolic excursion; IVRT, isovolumic relaxation time; ESS, end systolic stress; MAPSE, mitral annular plane systolic excursion

Keywords: cardiac function; sickle ß thalassaemia; echocardiography

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