الفهرس | Only 14 pages are availabe for public view |
Abstract Background : Ý-Thalassemia major (TM) and sickle cell disease (SCD) are inherited hemoglobin disorders resulting in chronic hemolytic anemia. Cardiovascular involvement is an important cause of morbidity and mortality in these groups of patients.The narrow border is between overt myocardial dysfunction and clinically silent left ventricular (LV) and / or right ventricular (RV) dysfunction in those patients.3 D Speckle tracking echocardiography (3D STE) is a novel method for detection of subclinical myocardial involvement. We aimed to assess LV and RV strain using 3 D speckle tracking echocardiography correlating them with aortic root stiffness parameter measured by speckle tracking and serum LDH. Methodology : Thirty SCD and thirty Ý TM patients, age range 4-18 years, were compared to 30 healthy age and sex matched control group. Cases were subjected to clinical examination, laboratory measurement of hemoglobin level, serum ferritin and LDH. Transthoracic color Doppler echocardiography, 3D STE, tissue Doppler echocardiography and aortic speckle tracking were performed. Results: significant reduction in global longitudinal strain (GLS), global circumferential strain (GCS) and global area strain (GAS) in SCD and TM than control (P value <0.001) there was significantly lower aortic speckle tracking in patients with TM and SCD than control (P value< 0.001). LDH was significantly higher in SCD than both TM and control and it correlated significantly positive with mitral inflow E, (p value:0.022 and 0.072. r: 0.416 and -0.333 respectively) lateral E/E{u2019} (p value.<0.001and 0.818. r. 0.618 and -0. 044.respectively) and septal E/E{u2019} (p value 0.007 and 0.753& r value 0.485 and -0.060 respectively) in SCD but not TM and significant negative correlation between LDH and aortic root speckle tracking (value 0.681& r. -0.078.) |