Left Ventricular Regional Function in Children with Beta Thalassemia with No Cardiac Manifestations (Four-Dimensional Echocardiographic Study)

  • Osama Abdrabelrasool El Razaky
  • Mohamed Ramadan El-ShanshoryEmail author
  • Waleed Ahmed El-Shehaby
  • Nahed Mohamed Hables
  • Adel Mohamed Elshamia
  • Ahmed Mohamed Fayed
  • Ahmed Elsayed El-Kholy
  • Esraa Ahmed El-Dosoky
Original Article


Early detection of myocardial dysfunction is essential for the management of patients with thalassemia. Four-dimensional echocardiography imaging technique may be useful for detecting subclinical cardiovascular disease. To evaluate the 4-dimensional echocardiographic strain in children with beta thalassemia major with no cardiac manifestation and correlate it with other echocardiographic parameters. This is a prospective cross-sectional cohort Study included 200 children, 1–18 years-old. They were divided into: One hundred children with p-Thalassemia major with no clinical cardiac manifestations and 100 healthy children as a control group. They were subjected to the following investigations: Complete blood count, serum ferritin and Four-dimensional echocardiographic strains (Longitudinal, Circumferential, Radial and Area strains). There was no significant difference between the two groups as regard mitral annulus systolic velocity (S wave), E/A ratio and iso-volumic acceleration, but there was a significant difference as regard to ejection fraction, left ventricle mass, sphericity index and myocardial performance index. The mean values of Left Ventricular Strains (Longitudinal, Circumferential, Radial and Area strains) were significantly lower in patients with thalassemia (− 14.86 ± 12.13, − 8.01 ± 3.829, 33.13 ± 10.61, − 19.45 ± 6.866) than controls (− 19.13 ± 1.502, − 16.32 ± 1.34, 37.28 ± 4.209, − 22.94 ± 3.06) than controls respectively with a positive correlation with 2-Dimensional strain. Strain parameters of the left ventricle obtained by four-dimensional.


Speckle tracking Four-Dimensional Echocardiography β-thalassemia major 


Author’s Contribution

The conception and design of the study by OAE, MRE. Acquisition of data by WAE. Analysis and interpretation of data by OAER, MRES. Drafting the article by AME, AMF, EAE. Revising it critically for important intellectual content by MRE, OAE and NMH. Final approval of the version to be submitted all authors.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

The study was approved by the ethical committee of the Faculty of Medicine, Tanta University. An informed consent was obtained from the guardian of all children and the study was conforming the declaration of Helsinki.


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Copyright information

© Indian Society of Hematology and Blood Transfusion 2019

Authors and Affiliations

  • Osama Abdrabelrasool El Razaky
    • 1
  • Mohamed Ramadan El-Shanshory
    • 1
    Email author
  • Waleed Ahmed El-Shehaby
    • 1
  • Nahed Mohamed Hables
    • 1
  • Adel Mohamed Elshamia
    • 2
  • Ahmed Mohamed Fayed
    • 2
  • Ahmed Elsayed El-Kholy
    • 2
  • Esraa Ahmed El-Dosoky
    • 2
  1. 1.Department of Pediatrics, Faculty of MedicineTanta UniversityTantaEgypt
  2. 2.Ministry of HealthCairoEgypt

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