Influence of Average Annual Mean Serum Ferritin Levels on Left Ventricular Function in Patients With β Thalassemia

Abstract

Cardiac complications are the most important cause of mortality and morbidity in Beta-Thalassemia Major (B-TM). The aim of our study was to determine the influence of Average Annual Mean Serum Ferritin (AAMSF) levels on cardiac function in patients suffering from B-TM. In this cross-sectional study, 50 patients of 5-15 years with B-TM were enrolled in the absence of clinical signs and symptoms of cardiac dysfunction. Left ventricular function was studied by using tissue Doppler image (TDI), pulse wave Doppler (PWD). AAMSF level was measured for 12 months. Patient groups were subdivided into two groups, group A with AAMSF level below 1000 ng/ml and group with B with AAMSF level above 1000 ng/ml. The Case group included 24(48%) males and 26(52%) females which were compared with 50 healthy subjects composed of 27(54%) males and 23 (46%) females (control group). The AAMSF Levels were 1054.60±687.95 ng/ml. By using PDW, in patients with AAMSF below 1000 ng/ml, The Parameters of the E, A, E/A E-DT had no significant difference with health groups (P=0.808, P=0.820, P=0.231 and P=0.061, respectively). No significant difference was revealed in parameters of E’, IVCT and ET in patients with AAMSF below 1000 ng/ml by using TDI in comparison to control (P=0.155, P=0.683, P=0.222, respectively).however, other TDI indexes including A’, E’/A’, IVRT, S,’ LVMPI, E/E’ had a significant difference with health group (P=0.014, P=0.041, P=0.045, P=0.002, P=0.021, and P=0.002, respectively). At patients with above AAMSF 1000 ng/mL, both PDW and TDI parameters had significant differences with the health group. There was no correlation among AAMSF levels and PWD or TDI indexes. The evidence from this study suggests that subclinical systolic and diastolic LV dysfunction has happened with AAMSF level above 1000 ng/ml, and according to our result, TDI is found more useful than PWD for subclinical cardiac evaluation.

Keywords

• Beta-thalassemia major
• Children
• Cardiac function
• Pulse wave doppler
• Serum ferritin
• Tissue doppler image