Assessment Of Left Ventricular Systolic Function In Patients With Iron Deficiency Anemia By Three-dimensional Speckle Tracking Echocardiography

Objective: The aim of this study was to assess the left ventricular systolic function in patients with iron deficiency anemia(IDA)by three-dimensional speckle tracking echocardiography(3D-STE).Methods: Sixty-five patients aged between 22 and 65 were diagnosed with IDA for more than 6 months.Exclusion criteria included valvular heart disease,diabetes mellitus,essential hypertension,chronic obstructive pulmonary disease,congenital heart disease,risk factors(dyslipidemia or smoking)or established cardiovascular disease.These people were divided into 2 groups with hemoglobin levels.Group B included 34 patients(Hb>90 g/L,aged 25~65 years,mean age: 48.8±14.1 years,disease duration 7 months to15 years,mean course of disease was 6.5±3.3 years)and group C included 31 patients(Hb in the range of 60~90 g/L,aged 22~62 years,mean age: 47.6±16.6 years,disease duration 8 months to14 years,mean course of disease was 6.2±3.6 years).The control group comprised of 30 age-and gender-matched healthy volunteers(aged 23~64 years,mean age: 47.0±14.5 years).None of the participants had been diagnosed with cardiovascular disorders and all examinations were normal.A complete physical examination was performed to all subjects.Their heights and weights were recorded.Body surface area and body mass index(BMI)were calculated of every individual.Blood pressures were measured for three times at a resting state for 15 minute,20 minutes interval between every two consecutive measurements.A 12-lead standard resting electrocardiogram was performed in all subjects.The parameters of the conventional echocardiography and 3D-STE were obtained respectively.The interventricular septum thickness diastolic(IVSTd),left ventricular posterior wall thickness diastolic(PWTd),left ventricular end diastolic diameter(LVDd),left ventricular end systolic diameter(LVDs)and E/A were respectively measured by conventional echocardiography.Left ventricular end-diastolic volume(LVEDV),left ventricular end systolic volume(LVESV),left ventricular mass index(LVMI)were measured and calculated by 3D technology.We used 3D-STE to analyze left ventricle global longitudinal strain(GLS),global area strain(GAS),global radial strain(GRS)and global circumferential strain(GCS).Results: 1.Conventional echocardiographyThe conventional echocardiographic parameters showed no differences between groups A and B(all P>0.05).Compared with groups A and B,E/A of Group C decreased remarkably(P<0.05),but other parameters were not significant(all P>0.05).2.3D parametersThere were no differences in LVMI,LVEDV and LVESV between the groups A and B(all P>0.05).The LVMI,LVEDV and LVESV of group C were increased significantly compared with those of groups A and B(all P<0.05).3.3D-STEThere were no differences between groups A and B in GLS?GAS?GRS and GCS(all P>0.05).Compared with groups A and B,GCS,GRS,GLS and GAS of group C were all decreased(all P<0.05),GAS and GLS decreased significantly(both P<0.01).Conclusions:1.Left ventricular systolic function decreased in the patients with moderate anemia.2.3D-STE can effectively assess left ventricular systolic function in patients with iron deficiency anemia.3D-STE provides a reliable method on the early diagnosis of left ventricular dysfunction and it can evaluate therapeutic effects of clinical treatment.