LEFT-VENTRICULAR FILLING PATTERN IN BETA-THALASSEMIA MAJOR - A DOPPLER ECHOCARDIOGRAPHIC STUDY

The pattern of left ventricular filling was assessed by Doppler echocardiography in 38 adult β-thalassaemia major patients; 28 with normal (age 25.2±5.3 years) and 10 with abnormal (age 24.5±8.8 years) left ventricular systolic function. The findings were compared with those obtained from 38 age and sex matched normal individuals.In patients with normal left ventricular systolic function, peak flow velocity in early diastole was higher than in the controls (94±16 vs 79±12 cm. s-1 P <0.001). The peak flow velocity in late diastole was also greater (60±18 vs 46±9cm. s-1 P <0.001) but the ratio between the early and late (atrial) peaks was approximately the same in both groups (1.74±0.72 vs 1.70±0.30 There was no difference in deceleration time and rate between the two groups (152±32 vs 151±21 ms and 504±93 vs 508±115 cm. s-2 respectively). None of the patients had atrial predominant left ventricular inflow pattern.In patients with congestive heart failure the peak flow velocity in early diastole was greater than in the controls (96±10 vs 79±2 cm. s-1 P < 0.001) while in late diastole it was smaller (39±6 vs 44±2 cm. s-1 P <0.05). The ratio between the early and late peaks was greater in the patients than in the controls (2.5±0.35 vs 1.8±0.08, P <0.001). The deceleration time and rate were not significantly different in the two groups (153±33 vs 152±17ms and 617±219 vs 550±56 cm. s-2 respectively), until the end stage of congestive heart failure. Thus, left ventricular filling pattern in β-thalassaemia major patients with normal left ventricular systolic function, is similar to that seen in conditions of an increased preload. Patterns compatible with abnormally prolonged relaxation or restriction do not appear. © 1993 The European Society of Cardiology.