Volume 12, Issue 1 (spring 2004)
JSSU 2004, 12(1): 56-64 |
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Noori N, Sohrevardi R. Evaluation of Myocardial Performance Index(Mpi) in Beta Thalassemia Major Patients at the Ali Asghar Hospital , Zahedan , Iran. JSSU 2004; 12 (1) :56-64
URL: http://jssu.ssu.ac.ir/article-1-1220-en.html
URL: http://jssu.ssu.ac.ir/article-1-1220-en.html
Abstract: (21272 Views)
Introduction : Patients with major thalassemia need recurrent transfusions and if not treated are at risk of heart dysfunction. Heart tissue could be abnormal in patients who use desferral continously due to iron deposits , fibrosis , hypertrophy and side effects of chronic anemia. Cardiac involvement is the main cause of morbidity and mortality in major thalassemics, so we decided to improve early diagnosis of cardiac involvement by measuring myocardial performance index( MPI ).
Method & Materials : This case-control study was performed from April 2003 to December 2003 at the Ali-Asghar pediatrics hospital, Zahedan, Iran. MPI of both ventricles was measured by Doppler echocardiography in 48 patients with major thalassemia aged between 10-18 years and compared with 48 age , sex-matched controls. Patients had no abnormality in physical examination , chest x-ray and ECG and echocardiography did not show heart failure. Hemoglobin and serum ferritin levels was measured in all patients before echocardiography.
Results: Mean age of patients was 12.3±2.4 years and that in the control group was 12.7±2years . Right ventricle isovolumetric relaxation time (RVIRT) (107 ± 14 vs 94 ±14 , p<0.001) and right ventricle isovolumetric contraction time (RVICT) (44 ± 20 vs 31 ± 23 , p<0.005) were prolonged in major thalassemia patients as compared to that in the control group, but ejection time was not significantly different in the patients and control group (260 ±29 vs 270 ± 23 , p>0.05). LVIRT (96 ±15 vs 89 ±16 , p>0.05) and LVICT (31 ± 13 vs 21 ± 15 , p<0.05) were prolonged in major thalassemia patients, but ejection time was not significantly different (263 ± 29 vs 270 ± 22 , p>0.05) in the two groups. Finally, RVMPI (0.59 ± 0.12 Vs 0.46 ± 0.12 , p<0.001) was increased in 87% of patients and LVMPI (0.49 ± 0.12 Vs 0.41± 0.09 , p<0.001) was increased in 73% of patients. There was a significant correlation between serum ferritin , RVMPI and LVMPI (r= 0.346 , p=0.016). How ever , there was no correlation between MPI and patient’s age (p>0.05).
Conclusion: This study showed that RVMPI and LVMPI increase in major thalassemia patients that indicates systolic and diastolic dysfunction and RVMPI increases more than LVMPI. On the other hand, MPI has a direct correlation with serum ferritin . On the basis of this study ,we suggest MPI measurement in serial echocardiography in asymptomatic major thalassemia patients.
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