Pulsed Doppler tissue imaging and myocardial function in thalassemia major.

Few studies are available on left ventricular diastolic function in beta-thalassemia major, and these have conflicting results. Our aim in this study was to analyze myocardial systolic and diastolic functions in patients with beta-thalassemia major using, for the first time, pulsed Doppler tissue imaging (DTI), and compare data with standard Doppler echocardiography. We studied 30 young patients with beta-thalassemia major (age </=16 years) with normal left ventricular systolic function and in 30 age and sex-matched controls using pulsed DTI, and compared the data with standard data obtained with Doppler echocardiography. In the beta-thalassemia major group before transfusion, early (E) and late (A) peak diastolic flow velocities were increased when compared with controls ( P = 0.0032 and P = 0.0039, respectively). The E/A ratio did not differ between the groups. All DTI parameters in the patients were similar to those of controls, except for lateral annulus ejection time adjusted for heart rate, that was significantly reduced when compared with healthy subjects ( P < 0.01). Multivariate analysis showed that ejection time adjusted for heart rate, has a significant relation with only E peak velocity ( P < 0.01) and left atrial size ( P < 0.01), two volume-dependent parameters. Our study shows that pulsed DTI parameters and standard Doppler left ventricular filling pattern in young beta-thalassemia major patients with normal left ventricular systolic function are similar to those seen in conditions of increased preload.