{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:18:43Z","timestamp":1785417523055,"version":"3.56.0"},"reference-count":40,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Deanship of Research and Graduate Studies at Ajman University","award":["2025-IDG-CEIT-4"],"award-info":[{"award-number":["2025-IDG-CEIT-4"]}]},{"award":["2025-IDG-CEIT-4"],"award-info":[{"award-number":["2025-IDG-CEIT-4"]}],"id":[{"id":"https:\/\/ror.org\/01j1rma10","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Myocardial iron overload is a major contributor to adverse cardiac outcomes in pediatric patients with transfusion-dependent \u03b2-thalassemia (TDT). Cardiovascular magnetic resonance (CMR), including T2* and T1 mapping, allows quantification of myocardial iron and early detection of cardiac dysfunction. Artificial intelligence (AI)-assisted CMR feature tracking (CMR-FT) provides a sensitive and reproducible approach for assessing myocardial deformation, even in patients with preserved left ventricular ejection fraction (LVEF). This study aimed to evaluate the utility of AI-based CMR-FT and its relationship with multiparametric CMR biomarkers, including myocardial strain (GCS, GLS, GRS), tissue characteristics (T2*, T1), and left ventricular (LV) geometry in pediatric TDT patients. Methods: In this retrospective study, 68 pediatric patients with \u03b2-thalassemia major and 20 age-matched healthy controls underwent CMR with T2*, T1 mapping, and FT-based strain analysis. Myocardial iron overload was defined as T2* &lt; 20 ms. Strain parameters were compared between groups, and correlations with tissue characteristics and LV geometry were assessed using Pearson\u2019s correlation. Results: Patients with myocardial iron overload have significantly reduced GCS compared to controls (\u221217.4 \u00b1 1.6% vs. \u221219.3 \u00b1 4.5%, p &lt; 0.01). GCS correlated with T2* (r = \u22120.33, p = 0.007) and T1 (r = \u22120.45, p &lt; 0.001). GLS was sensitive to LV geometric changes, particularly concentric remodeling, correlating with LV mass\/EDV ratio (r = \u22120.449, p &lt; 0.001). Conclusions: AI-based CMR-FT combined with multiparametric tissue imaging enhances early detection of subclinical myocardial dysfunction in pediatric TDT, offering diagnostic insights beyond conventional CMR metrics and supporting improved risk stratification.<\/jats:p>","DOI":"10.3390\/diagnostics16142139","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T15:40:09Z","timestamp":1783525209000},"page":"2139","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessment of Myocardial Iron Overload and Strain Abnormalities in Pediatric \u03b2-Thalassemia Using Multiparametric CMR"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4832-4576","authenticated-orcid":false,"given":"Rania","family":"Awadi","sequence":"first","affiliation":[{"name":"Research Laboratory of Biophysics and Medical Technologies, The Higher Institute of Medical Technologies of Tunis, University of Tunis El Manar, Tunis 1006, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narjes","family":"Benameur","sequence":"additional","affiliation":[{"name":"Research Laboratory of Biophysics and Medical Technologies, The Higher Institute of Medical Technologies of Tunis, University of Tunis El Manar, Tunis 1006, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5287-1874","authenticated-orcid":false,"given":"Mohamed","family":"Deriche","sequence":"additional","affiliation":[{"name":"Artificial Intelligence Research Centre, Ajman University, Ajman P.O. Box 346, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilhem Ben","family":"Fraj","sequence":"additional","affiliation":[{"name":"National Center of Bone Marrow Transplantation, Department of Pediatrics Immunohematology and Stem Cell Transplantation, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis 1007, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seif","family":"Boukhriba","sequence":"additional","affiliation":[{"name":"Radiology Department, La Rabta Teaching Hospital, Tunis 1007, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aicha Ben","family":"Taieb","sequence":"additional","affiliation":[{"name":"National Center of Bone Marrow Transplantation, Department of Pediatrics Immunohematology and Stem Cell Transplantation, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis 1007, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3642-6743","authenticated-orcid":false,"given":"Monia","family":"Ouedreni","sequence":"additional","affiliation":[{"name":"National Center of Bone Marrow Transplantation, Department of Pediatrics Immunohematology and Stem Cell Transplantation, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis 1007, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salam","family":"Labidi","sequence":"additional","affiliation":[{"name":"Research Laboratory of Biophysics and Medical Technologies, The Higher Institute of Medical Technologies of Tunis, University of Tunis El Manar, Tunis 1006, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"060002","DOI":"10.1063\/5.0048857","article-title":"Uncover molecular network between beta thalassemia and retinal abnormality through in silico study","volume":"2344","author":"Sumantri","year":"2021","journal-title":"AIP Conf. 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