DIASTOLIC FILLING ABNORMALITIES IN ASYMPTOMATIC PATIENTS WITH THALASSEMIA MAJOR - CORRELATION WITH IRON LOADING STATUS

Doppler echocardiographic indexes of left ventricular diastolic filling were determined for 30 asymptomatic patients with beta-thalassemia major with normal echocardiographic systolic function and compared to 21 normal controls. Significant differences were found for acceleration time and EF slope. Diastolic filling parameters were then analyzed in relation to the ratio of total transfusional iron load to cumulative deferoxamine (DFO). Significant correlations were found for E velocity, deceleration time, and acceleration time. The results support a previously documented finding of restrictive physiology in thalassemic patients but also suggest that there may be a component of impaired relaxation. This study demonstrates that there is a spectrum of diastolic abnormalities observed in patients with beta-thalassemia, and that their diastolic filling parameters vary with degree of compliance with chelation and/or iron loading. These parameters may be useful in determining disease progression, in making decisions regarding therapy, and in predicting outcome.