Spring 2004; 47(83):79-89

QUANTITATIVE ASSESSMENT OF CARDIAC FUNCTION IN CHILDREN WITH BETA- THALASSEMIA MAJOR, USING THE DOPPLER MYOCARDIAL PERFORMANCE INDEX

MOTTAGHI MOGHADDAM H.,ALIZADEH B.,BANIHASHEM A.,AFZALNIA S

Introduction: Cardiac disease and early death due to myocardial injuries because of Iron overload and hemosiderosis are still the major problems in the management of patients with beta-thalassemia major (BTM). Valuable echocardiographic techniques have been limited in early detection of cardiac dysfunction in these patients. A new Doppler index combining systolic and diastolic time intervals (the Tei index) has been reported to be useful for assessment of global ventricular function in many cardiac diseases. The purpose of this study was to assess global ventricular function in children with BTM using Tei index and also to determine its correlation with hematologic parameters.
Material and Methods: This analytic cross sectional study was performed on 59 patient with Beta-Thalassemia Major during Jan.2003 until Feb.2004 in hematologic clinics of Imam Reza and Dr. Sheikh Hospitals. Complete physical examination and Doppler Echocardiographic study was done for all the patients and patients Tei indexes were compared with normal values in other studies statistically.
Results: The mean Tei index of left ventricule (LV) and right ventricule (RV) was 0.35±0.11 (mean±SD) and 0.28±0.12 (mean±SD) respectively. There was a significant difference between both right and left ventricular Tei index in-patients with BTM and healthy children. There was also a significant correlation between mean blood transfused volume per year and Tei index in both right (PV? 0.05) and left ventricule (PV? 0.05). We also find a significant difference between two groups of thalassemic patients according to their mean pre-transfused Hgb per year (Hgb? 9 g/dl and Hgb >9 g/lit) for left ventricular Tei index.
Conclusion: The Tei index is a simple, feasible and reproducible measure of global cardiac function in-patients with BTM with early myocardial dysfunction.