Background. Diastolic left ventricular function expressed by diastolic
Doppler characteristics of the left ventricle has never been properly
investigated. Methods and Results. Left ventricular inflow and pulmon
ary vein flow patterns were assessed hy Doppler echocardiography in 88
beta-thalassemia major patients with normal left ventricular systolic
function; 34 were young (age, 15.1+/-3.2 years) and 54 were adults (a
ge, 25.1+/-3.6 years). The findings were compared with those obtained
from 22 young (age, 13.8+/-2.4 years) and 24 adult (age, 25.3+/-4.1 ye
ars) normal individuals. In both groups of patients, peak flow velocit
ies in early (E).and late (A) diastole were higher than in the control
subjects (young E: P<.01; adult E: P<.001; young A: P<.05; adult A: P
<.05), whereas no difference was found in the E/A ratio, deceleration
time, or isovolumic relaxation time. Pulmonary vein systolic (S) and d
iastolic (D) velocities were also higher in beta-thalassemia major pat
ients compared with the control subjects (young S: P<.05; adult S: P<.
05; young D: P<.05; adult D: P<.05). Restrictive left ventricular abno
rmalities were only found in 7 patients who were among the oldest beta
-thalassemia major population of the adult group (P<.01) with highly e
levated mean serum ferritin. In comparison to the remaining adult pati
ents, interventricular septum and left ventricular posterior wall thic
kness were increased (P<.01 and P<.01, respectively). The left atrium
and right ventricle were dilated (P<.05 and P<.01, respectively). Conc
lusions. Doppler diastolic indexes in beta-thalassemia major patients
with normal left ventricular systolic function are similar to those se
en in conditions with an increased preload, probably because of chroni
c anemia. Only severe iron loading and deposition in the myocardium le
ads to the restrictive abnormalities of left ventricular filling.