The Effects of Vitamin D on Myocardial Function Demonstrated by Speckle-Tracking Echocardiography in Children with Beta Thalassemia.

Ayça Koca Yozgat, Emine Azak, Dilek Kaçar, Melek Işık, Özlem Arman Bilir, Zeliha Güzelküçük, İbrahim İlker Çetin, Namık Yaşar Özbek, Neşe Yaralı
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Abstract

Objective: Beta thalassemia major is an inherited hemoglobin disorder resulting in chronic hemolytic anemia. Cardiac involvement is the main cause of death in patients. Speckle-tracking echocardiography is a feasible method for the evaluation of cardiac function via an assessment of the longitudinal deformation of the myocardium through the cardiac cycle. The aim of our study is to evaluate the association between vitamin D deficiency and deformation of the left ventricular myocardium measured by speckle-tracking echocardiography in children with thalassemia major.

Methods: In this prospective study, 33 thalassemic patients with vitamin D deficiency were enrolled. Cardiac magnetic resonance T2* value, conventional echocardiography, and speckle tracking, and also left ventricular longitudinal and circumferential strain values were measured. Myocardial functions of the patients with vitamin D deficiency or insufficiency were evaluated by speckle-tracking echocardiography before and after vitamin D replacement.

Results: The mean age of the patients was 15.4 ± 3.09 years. Vitamin D level was deficient in 30 (90%) and insufficient in 3 (10%) of them. Speckle-tracking analysis showed a significantly decreased absolute value of the left ventricular global longitudinal strain before vitamin D replacement. A significant improvement in the global longitudinal strain was detected after vitamin D replacement (P < 0.05). A statistically significant increase was observed in parameters showing left ventricular systolic and diastolic functions after vitamin D replacement.

Conclusion: Vitamin D deficiency is frequently observed and causes decreased contractility in thalassemic patients. In our study, we observed that our patients' cardiac functions had improved after vitamin D replacement therapy.

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斑点追踪超声心动图显示维生素D对地中海贫血儿童心肌功能的影响。
目的:乙型地中海贫血是一种遗传性血红蛋白疾病,导致慢性溶血性贫血。心脏受累是患者死亡的主要原因。斑点跟踪超声心动图是一种可行的方法,通过评估心脏周期中心肌的纵向变形来评估心功能。我们的研究目的是评估维生素D缺乏与斑点跟踪超声心动图测量的地中海贫血儿童左心室心肌变形之间的关系。方法:在这项前瞻性研究中,33例地中海贫血维生素D缺乏症患者入组。测量心脏磁共振T2*值、常规超声心动图、斑点跟踪及左室纵、周应变值。采用斑点追踪超声心动图评价维生素D缺乏或不足患者在补充维生素D前后的心肌功能。结果:患者平均年龄15.4±3.09岁。其中30人(90%)缺乏维生素D, 3人(10%)缺乏维生素D。斑点跟踪分析显示,维生素D替代前左心室整体纵向应变绝对值显著降低。维生素D替代后整体纵向应变有显著改善(P < 0.05)。在维生素D替代后,左心室收缩和舒张功能的参数有统计学意义的增加。结论:维生素D缺乏是地中海贫血患者经常观察到的,并导致收缩能力下降。在我们的研究中,我们观察到患者的心脏功能在维生素D替代治疗后得到了改善。
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来源期刊
CiteScore
1.30
自引率
12.50%
发文量
124
审稿时长
32 weeks
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