AI Summary & Key Takeaways
AI InsightE/Eʹ parameterhad a sensitivity and specificity of 76.5% and 53.1% respectively at a meanserum ferritin cutoff level of 2076 ng/mL by ROC analysis.In conclusion, TDI is a more reliable modality for diagnosing early diastolicdysfunction when compared to PWD.
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Özet
Regular blood transfusions for children with beta thalassemia major (βTM) results in iron overload cardiomyopathy/cardiac failure. Mortality inthese children is most often because of heart failure. We compared TissueDoppler Imaging (TDI) and conventional pulse wave Doppler (PWD) indicesin evaluating diastolic function in chronically transfused β-TM children andcorrelated the Doppler indices with mean serum ferritin levels.This was a prospective cross-sectional study conducted at tertiary teachinghospital. β-TM children aged 3 to 18 years were enrolled as per inclusioncriteria. PWD parameters at the mitral inflow (E, A, E/A and DT) and TDIparameters at the medial mitral annulus (Eʹand E/Eʹ) were used for estimationof diastolic dysfunction.Of the 66 children with thalassemia, the mean age was 10.2±3.77yrs and60.6% were boys. The E/Eʹ ratio estimated diastolic dysfunction (34/66, 51.5%)greater than four times that assessed by E/A ratio indices (8/66, 12.1%) inthe subjects. Association of serum ferritin levels with E/Eʹ ratio by chi squaretest was significant statistically (P=0.027), however was not significant withE/A ratio. By Mann Whitney test, the median serum ferritin levels (ng/ml)were higher [4034.50, (IQR-2084-5340.25) in those with diastolic dysfunction(abnormal E/Eʹ), when compared to those with normal E/Eʹ[2037.50(1510.75-3572.25)], with their difference being significant (p=0.011), however serumferritin levels were not significant with E/A ratio and DT. E/Eʹ parameterhad a sensitivity and specificity of 76.5% and 53.1% respectively at a meanserum ferritin cutoff level of 2076 ng/mL by ROC analysis.In conclusion, TDI is a more reliable modality for diagnosing early diastolicdysfunction when compared to PWD. Threshold level of serum ferritin greaterthan 2076 ng/mL is associated with increased incidence of diastolic dysfunction.