Echocardiographic predictors of adverse cardiac events in asymptomatic beta thalassemic patients.
Journal Title: Journal of Medical Science and Technology - Year 2015, Vol 4, Issue 2
Abstract
Aim of study was to identify echocardiographic parameters related to the development of future adverse events (AEs) in asymptomatic thalassemic patients (TM). A total of 74 TM patients (TM group) and 22 healthy subjects (HS group) were included in the study. All subjects underwent standard echocardiography with Tissue Doppler Imaging (TDI). The follow up was for 974 ± 275 days. When compared to HS, TM showed a significant increase of LV Mass index (LVMi), diastolic (LVEDV) and systolic (LVESV) volume (p=0.001, p=0.001 and p=0.023, respectively). TDI analysis identified a significant impairment of S’, E’ and A’ wave mean values (p<0.001, p<0.001 and p=0.002 respectively). Left atrial volume index and the E/E’ ratio were significantly increased in TM (p<0.001). LV ejection fraction was preserved. At follow up, 10 AEs were observed in TM: one death from cardiac cause, 6 patients developing heart failure, 3 new detected supra-ventricular arrhythmias. In TM, ROC curve analysis identified LVEDV>122 ml, LVESV >46 ml, LVMi >82.1 g/m2, E/A ratio>2.09, S’ wave<6.2 cm/sec, E’ wave<10 cm/sec, A’ wave<5 cm/sec and E/E’ ratio >7.82 as cut off-values differentiating TM patients with AEs. On multivariate logistic regression analysis, the E/E’ ratio (Exp (B) = 1.623, p=0.038) and the A’ velocity (Exp (B)=0.509, p=0.044) were independent predictors of AEs at follow up. The TDI derived parameters are useful for the prognostic stratification of asymptomatic TM and easy to use. Early identification of subclinical myocardial dysfunction based on these parameters could be useful for the optimization of therapeutic strategies and correct risk stratification.
Authors and Affiliations
Ines Monte, Sergio Buccheri, Stefano Leggio
Keywords
Related Articles
- EP ID EP95386
- DOI -
- Views 207
- Downloads 0
redisposing factors of high Lipoprotein(a) in HIV positive patients on HAART at Livingstone General Hospital, Zambia.
Lipoprotein(a) (Lp(a)) is a highly atherogenic independent risk marker for Cardiovascular disease (CVD). Current studies show that Highly Active antiretroviral Therapy (HAART) raises Lp(a) levels in HIV patients, t...
Etiology and treatment outcome of traumatic brain injuries from assault
Conflicts among humans have been for food, sex, and territory. The brain is the most targeted organ. Direct or indirect injury to the brain could spell disaster. Humans apply both blunt and penetrating trauma to the head...
Characterization of antimicrobial resistance in Salmonella enterica Serovars Typhi and paratyphi B in Zambia.
Typhoidal Salmonellae are invasive and life-threatening human pathogens that cause typhoid and paratyphoid fever in many low income countries globally. People consuming contaminated food, water or working with infe...
Banana Medicinal Uses.
Banana (Genus Musa) cultivars are grown from long time throughout the world. All parts of banana have nutritional and traditional medicinal uses. Many in vitro studies , animal model studies and clinical studies suggest...