Tissue Doppler Echocardiography in Detection of Myocardial Iron Overload Confirmed by Cardiac MRI in Patients With Beta Thalassemia Major: A Meta-Analysis

摘要: Background: Myocardial iron overload is the most serious complication seen in transfusion-dependent beta thalassemia. Congestive heart failure remains to be leading cause of death thalassemia major patients. It therefore important facilitate early detection myocardial affected patients avoid inevitable complications treatment. Cardiac magnetic resonance imaging (MRI) continues gold standard detecting myocardial overload as it sensitive and precise procedure available. however expensive, time-consuming not universally available all institutions. These reasons preclude from being widely utilized our practice. Tissue Doppler echocardiography on other hand available, faster has significantly lower costs than latter. characteristics make a promising alternative diagnostic tool for screening cardiac overload. This study aims determine the correlation tissue echo parameters compared current standard, MRI T2 star. Methods: A literature search published English language studies was performed using PubMed, MEDLINE Cochrane Collaboration from 1990 2013. Articles included were prospective cross-sectional case-control trials. The risk bias assessment (PRISMA) feature Revman 5.0 and QUADAS criteria used qualify validity said qualified studies. Results: Five prospective observational with total 276 subjects. Four analyzed to T2* findings. Results showed that some degree overload, evident CMR < 20 ms, had statistically significant decrease left ventricular ejection fraction (LVEF) an overall mean difference (MD) -3.84 (-5.85, -1.83) (Z = 3.75, P 0.0002); increased Tei index (MD 13.03 (9.77, 16.99), Z 7.83, 0.00001); shorter deceleration times -27.10 (-33.50, -20.71), 8.31, 0.00001). There no difference E/A ratio normal subjects versus overloaded patients 0.18 (0.09, 0.27)) reliable parameter gauge 3.88, 0.0001). Conclusion: have good with T2*, current are index, deceleration time LVEF. J Hematol. 2014;3(1):1-9 doi: http://dx.doi.org/10.14740/jh107w