Open AccessThe early cardiac involvement in patients with β-thalassemia major
Author(s) -
Samira Sayed,
Basma A Aly,
Abd El-Hakim A Abd El-Hakim,
Suzan Omar,
Amr Amin
Publication year - 2013
Publication title -
the egyptian heart journal /the egyptian heart journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.212
H-Index - 9
eISSN - 2090-911X
pISSN - 1110-2608
DOI - 10.1016/j.ehj.2013.01.002
Subject(s) - medicine , cardiology , ejection fraction , ventricle , diastole , ferritin , thalassemia , qt interval , diastolic function , cardiac function curve , doppler imaging , heart failure , blood pressure
Background: Cardiac complications, heart failure and arrhythmias remain the major causes of death in thalassemia major.Aim: To detect the early cardiac involvement in β-thalassemic patients.Patients and methods: 56 Patients (pts) with β-thalassemia major and transfusion burden ⩾12 times/year (age 6–16 years) were included in our study, classified into three groups according to serum ferritin, group I: 21 pts with ferritin level <2500 ng/ml, group II: 23 pts with ferritin level 2500–5000 and group III: 12 pts with ferritin level >5000 ng/ml. They were subjected to detailed clinical evaluation, routine laboratory investigations, serum ferritin level, ECG {corrected QT intervals (QTc) and QT dispersion(QTd)}, echocardiography for measurement of left atrial (LA) active emptying fraction, Systolic (peak systolic wave, Q–S peak duration) and diastolic functions of left ventricle using standard and tissue Doppler imaging (TDI).Results: Groups III and II showed a significant increase in LV septal and posterior wall thickness than group I while QTc and QTd were increased significantly only in group III compared to group I (P = 0.00, 0.01). LV diastolic function and LA active emptying fraction were significantly impaired in group III and II compared to group I while LV systolic function parameters by TDI were impaired significantly in group III compared to group I with insignificant difference by standard echocardiography.Conclusion: The increase in LV septal and posterior wall thickness precedes ECG changes. Also LV diastolic dysfunction and impaired LA active emptying fraction precede LV systolic dysfunction