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European Journal of Heart Failure Advance Access originally published online on November 4, 2009
European Journal of Heart Failure 2009 11(12):1178-1181; doi:10.1093/eurjhf/hfp152
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org.

Cardiac mortality in β-thalassemia major: resting but not dobutamine stress echocardiography predicts mortality among initially cardiac disease-free patients in a prospective 12-year study

George Hahalis1,*, Alexandra Kourakli2, Ioanna Gerasimidou1, Andreas P. Kalogeropoulos1, George Sitafidis1, Urania Papageorgiou3, Periklis Davlouros1, Nikos Grapsas4, Nicholas C. Zoumbos2 and Dimitrios Alexopoulos1

1 Department of Cardiology, Patras University Medical School, 7 Larnakos Street, Rio, Patras 26441, Greece
2 Department of Hematology, Patras University Medical School, Rio, Patras, Greece
3 Department of Hematology, Karamandaneio Hospital, Patras, Greece
4 Department of Cardiology, Agios Andreas Hospital, Patras, Greece

* Corresponding author. Email: ghahalis@otenet.gr

Received May 10, 2009; Revised August 9, 2009; Accepted August 26, 2009

The first 150 words of the full text of this article appear below.


   Background
 
Heart failure as a result of impaired right or left ventricular (LV) systolic function remains the principal cause of mortality among patients with β-thalassemia major (β-TM).1–4 It has been hypothesized that latent myocardial dysfunction may be present in β-TM due to altered ventricular loading conditions (i.e. ‘pseudo-normal’ systolic function); and if detected, this condition warrants more intensified chelation therapy. In fact, subclinical ventricular dysfunction revealed during stress, including inotropic myocardial challenge, has been shown to be associated with adverse outcomes despite an apparently normal resting LV ejection fraction (LVEF).5–13 However, the incremental value of dobutamine stress echocardiography (DSE) or similar procedures as prognostic tools in β-TM in addition to clinical background remains unclear.12,13


   Aims
 
In this study, we prospectively investigated whether DSE could provide additional prognostic information beyond that provided by the clinical evaluation in adult patients with β-TM who were cardiac disease-free and exhibited initially normal biventricular systolic function. The . . . [Full Text of this Article]


   Methods
 

   Results
 

   Conclusion
 

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