目的:这项横断面研究的目的是研究左心房(LA)应变参数与人口统计学的关系,临床资料,心血管磁共振(CMR)的发现,一组β-地中海贫血(β-TM)患者的心脏并发症(心力衰竭和心律失常)。
方法:我们考虑了264例β-TM患者(133例女性,36.79±11.95年)连续参加地中海贫血延伸心肌铁过载(E-MIOT)项目。此外,我们纳入了35名性别和年龄匹配的健康对照(14名女性,平均年龄37.36±17.52岁)。蓄水池,导管,和助推器LA功能通过使用专用软件的CMR特征跟踪进行分析。
结果:与健康对照组相比,β-TM患者表现出较低的LA储层应变和增强应变,以及洛杉矶水库和助推器应变率。然而,LA导管变形参数无差异。在β-TM患者中,老化,性别,和左心室(LV)容积指数是LA应变参数的独立决定因素。具有晚钆增强(LGE)的段的数量与所有LA应变参数显著相关,除了LA导管速率。与没有心脏并发症的患者相比,有心脏并发症的患者的应变参数显着受损。
结论:在β-TM患者中,与对照组相比,LA应变参数受损,它们与LGE的LV节段数显着相关。此外,有心脏并发症的患者左心房应变参数受损.临床相关性陈述重型β地中海贫血患者,与对照组相比,左心房应变参数受损,并成为心脏并发症的敏感标志物,强于心脏铁水平。
结论:•与健康受试者相比,β-地中海贫血主要患者表现出明显较低的左心房储层应变和加强应变,以及左心房储液器和助推器应变率。•在重型β-地中海贫血中,老化,性别,左心室容积指数是左心房应变参数的独立决定因素,而左心房应变参数与心肌铁超负荷无关。•在β-地中海贫血主要患者中发现左心房应变参数降低与心脏并发症病史之间的独立关联。
OBJECTIVE: The aim of this cross-sectional
study was to investigate the association of left atrial (LA) strain parameters with demographics, clinical data, cardiovascular magnetic resonance (CMR) findings, and cardiac complications (heart failure and arrhythmias) in a cohort of patients with β-thalassemia major (β-TM).
METHODS: We considered 264 β-TM patients (133 females, 36.79 ± 11.95 years) consecutively enrolled in the Extension-Myocardial Iron Overload in Thalassemia (E-MIOT) project. Moreover, we included 35 sex- and age-matched healthy controls (14 females, mean age 37.36 ± 17.52 years). Reservoir, conduit, and booster LA functions were analysed by CMR feature tracking using dedicated software.
RESULTS: Compared to the healthy control group, β-TM patients demonstrated lower LA reservoir strain and booster strains, as well as LA reservoir and booster strain rates. However, no differences were found in LA conduit deformation parameters. In β-TM patients, ageing, sex, and left ventricle (LV) volume indexes were independent determinants of LA strain parameters. The number of segments with late gadolinium enhancement (LGE) significantly correlated with all LA strain parameters, with the exception of the LA conduit rate. Patients with cardiac complications exhibited significantly impaired strain parameters compared to patients without cardiac complications.
CONCLUSIONS: In patients with β-TM, LA strain parameters were impaired compared to control subjects, and they exhibited a significant correlation with the number of LV segments with LGE. Furthermore, patients with cardiac complications had impaired left atrial strain parameters. Clinical relevance statement In patients with β-thalassemia major, left atrial strain parameters were impaired compared to control subjects and emerged as a sensitive marker of cardiac complications, stronger than cardiac iron levels.
CONCLUSIONS: • Compared to healthy subjects, β-thalassemia major patients demonstrated significantly lower left atrial reservoir strain and booster strains, as well as left atrial reservoir and booster strain rates. • In β-thalassemia major, ageing, sex, and left ventricular volume indexes were independent determinants of left atrial strain parameters, while left atrial strain parameters were not correlated with myocardial iron overload. • An independent association between reduced left atrial strain parameters and a history of cardiac complications was found in β-thalassemia major patients.