Objective: Cardiac pathology (CCF) secondary to iron deposition; fibrosis; hypertrophy and structural effect of anemia, is major cause of death in chronically transfused patients with ß thalassemia major.
Material & Methods: Present study comprised 30 patients with ß thalassemia major who were evaluated clinically and by 2-D Echo, conventional Doppler and by tissue Doppler imaging for determining LV diastolic function.
Serum Ferritin levels were also studied.
Findings were compared with age and sex matches controls
Difference between continuous variables were determined using unpaired student ’t’ test.
Results:
| - |
Patient |
Control
|
P-Value
|
Clinical
Age (years)
Sex
Hemoglobin (gm%)
Ferritin (ng/ml)
Average no. of transfusions/year
|
10.8 ± 3.1
17F, 18M
8.58 ± 1.44
8370.85 ± 2666.35
16.28 ± 5.5
|
8.24 ± 2.86
19F, 16M
10.72 ± 0.64
100.55 ± 38.44
Nil
|
-
-
-
- |
2-D Echo
EF (%)
LVMI
|
65.55 ± 8.98
153 ± 54.52
|
63.87 ± 16.35
1103 ± 29.8
|
NS
<0.001
|
Conventional Doppler
E/A
E/Ea
IVRT
DT
|
1.974 ± 0.729
44.6 ± 19.98
191.5 ± 55.88
|
2.11 ± 0.93
36.67 ± 5.12
138.5 ± 34.81
|
NS
0.0001
0.05 |
Tissue Doppler
E/Ea
|
10.14 ± 2.07 |
6.17 ± 2.44
|
0.0001
|
Conclusion:
- Left ventricular diastolic dysfunction is detected in patients with ß thalassemia major even before appearance of systolic dysfunction and clinical features of CCF.
- No significant co-relation could be established between hematological parameters like serum ferritin; rate of transfusion with Doppler diastolic indices.
