Left and Right Atrial Function and Remodeling in Beta-Thalassaemia Major

  • Yiu-fai CheungEmail author
  • Edwina Kam-fung So
  • Gloria Yu-yan Hwang
  • Godfrey Chi-fung Chan
  • Shau-yin Ha
Original Article


This study aimed to assess left (LA) and right atrial (RA) function in patients with beta-thalassaemia major. Thirty-eight patients (19 males) aged 34.5 ± 10.7 years and 43 (18 males) controls aged 30.3 ± 12.6 years (p = 0.12) were studied. The maximum RA and LA areas were measured using two-dimensional planimetry, while atrial and ventricular strain and strain rates were quantified using speckle-tracking echocardiography. Compared with controls, patients had significantly reduced LA and RA peak positive strain and total strain, and LA strain rate during ventricular systole and at atrial contraction (all p < 0.05). The LA and RA strain parameters were significantly associated (all p < 0.05). The maximum LA (10.2 ± 1.6 cm2/m2 vs. 8.6 ± 1.3 cm2/m2, p < 0.001) and RA (9.2 ± 1.2 cm2/m2 vs. 7.5 ± 1.3 cm2/m2, p < 0.001) areas were significantly greater in patients than controls. The LV and RV strain and early strain rates were similar between patients and controls (all p > 0.05). Four patients with significant myocardial iron overload had larger LA area (p < 0.001) than those without. Functional and structural remodeling of both the right and left atria occurs in patients with beta-thalassaemia major, even in the absence of ventricular diastolic dysfunction.


Beta-thalassemia major Atrial function Strain 



The Children’s Thalassaemia Foundation, Hong Kong, China.


This study is supported by the Children’s Thalassaemia Foundation, Hong Kong, China (Grant no. 2015/07).

Compliance with Ethical Standards

Conflict of interest

All of the authors declare no conflict of interest.

Ethical Approval

The review of records and echocardiographic assessment in all of the study subjects and the need to obtain informed consent, was approved by the Institutional Review Board of the University of Hong Kong/Hospital Authority Hong Kong West Cluster, Hong Kong, China, and in accordance with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Paediatrics and Adolescent Medicine, Queen Mary HospitalThe University of Hong KongHong KongChina
  2. 2.Department of Medicine, Queen Mary HospitalThe University of Hong KongHong KongChina
  3. 3.Division of Paediatric Cardiology, Department of Paediatrics and Adolescent Medicine, Queen Mary HospitalThe University of Hong KongHong KongChina

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