Assessment of LV Diastolic Function in Patients with Beta-thalassemia Major with Special Reference to E/Eann Ratio

Objective: The present study was undertaken to evaluate left ventricular function in patients with beta-thalassemia major with special reference to pulsed wave tissue Doppler imaging.

Methods: The present study compared 30 diagnosed cases of beta-thalassemia major (mean age: 9.43+/-2.78 y) with 30 age-sex-matched healthy controls (mean age: 8.3+/-2.83 y) for left ventricular function assessment using following parameters: ejection fraction, mitral valve E/A ratio and E deceleration time (Edec), isovolumic relaxation time, and E/Eann ratio. Serum ferritin levels were also measured.

Results: There was significant increase in E/Eann (9.46+/-1.5 vs. 6.16+/-2.4, P<0.0001) and significant prolongation of Edec (177.66+/-40.73 vs. 138.5, P<0.001) and isovolumic relaxation time (40.2+/-14.89 vs. 36.67+/-5.12, P<0.05) in cases as compared with controls. However, there was no significant difference in ejection fraction value (65.55+/-8.98 vs. 63.87+/-16.35) and E/A ratio (2.0386+/-0.73 vs. 2.119+/-0.92). Serum ferritin levels although increased significantly in cases (8370.85+/-2660.35), no correlation could be established between increased serum ferritin and progressive diastolic dysfunction (r=0.148, P=0.258).

Conclusions: Diastolic dysfunction precedes systolic dysfunction in patients with beta-thalassemia major as assessed by Edec and E/Eann ratio.