@article{3117008,
    title = "Predictive echo-Doppler indices of left ventricular impairment in
B-thalassemic patients",
    author = "Aessopos, Athanassios and Deftereos, Spyros and Tsironi, Maria and and Karabatsos, Fotios and Yousef, Jacqueline and Fragodimitri, Christina and and Hatziliami, Antonia and Karagiorga, Markissia",
    journal = "Annals of Hematology",
    year = "2007",
    volume = "86",
    number = "6",
    pages = "429-434",
    publisher = "Springer-Verlag",
    issn = "0939-5555, 1432-0584",
    doi = "10.1007/s00277-007-0257-y",
    keywords = "heart dysfunction; beta-thalassemia; chelation; echocardiography",
    abstract = "Early detection of cardiac-function impairment by echo-Doppler indices
can assist in preventing further cardiac damage by modifying disease
progression and treatment. We analyzed our thalassemia major patients
database with 10 years cardiac follow-up. Included patients were under
constant therapy and should have an initial echo-Doppler study with
normal Shortening Fraction ( SF > 30%) and reexamination within the
last year. We identified patients who developed impaired left
ventricular (LV) function in the last Echo and we attempted to find
which measured indices could predict LV function impairment. Three
hundred fifteen of the 632 database patients were enrolled. Twelve of
them developed LV systolic dysfunction. There were no statistically
significant differences in mean age, ferritin, and pretransfusion
hemoglobin levels of the two groups. LV-systolic-dysfunction group was
presenting statistically significantly higher LF end-systolic diameter
(LVESD) index, lower SF, higher early transmitral peak flow
velocities/late transmitral peak flow velocities ( A) ratios, lower A
value. All other echocardiographic parameters did not differ
significantly. By receiver-operating characteristic analysis, we
determined systolic and diastolic indices specificity and sensitivity
for LV impairment: LVESD 97% specificity, 11% sensitivity ( cutoff
value 2.44 cm/m(2)), SF 92.1 and 33.3% ( cutoff value 33%). Regarding
diastolic indices, A index was the best criterion ( 97.7% specificity,
25% sensitivity, cutoff value <= 0.36). Low values of the diastolic
index A wave and increased values of the LVESD index were the earliest
pathological findings in patients that finally developed LV systolic
dysfunction. These parameters could be used as heart-dysfunction
predictors with relatively good sensitivity and specificity."
}