Majallah-i Dānishgāh-i ’Ulūm-i Pizishkī-i Shahīd Ṣadūqī Yazd (Apr 2004)
Evaluation of Myocardial Performance Index(Mpi) in Beta Thalassemia Major Patients at the Ali Asghar Hospital , Zahedan , Iran
Abstract
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 , p0.05) and LVICT (31 ± 13 vs 21 ± 15 , p0.05) 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 , p0.05). 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.
