Potential effect of β thalassemia major on cardiac function among patients in Jeddah, Saudi Arabia

Abstract

The present studydetect the prevalence of cardiac complications and the efficacy of iron overload monitoring by ECHO (LVEF), and serum ferritin assay in patients at Department of Clinical Hematology with β thalassemia major (βTM). Case records of all βTM patients were analyzed for clinical data, age, sex, heart failure, serum ferritin, ECG, chest x-ray and echocardiography. Sixty -two βTM patients with serially recorded LVEF are included in statistical analysis. Age range of these patients was 4-36 years. Clinical congestive cardiac failure (CHF) was observed in 5 patients(6.45%) with the age range of 13-28 years, 34 patients (54.8%) have normal ECHO findings while 28 patients (45.2%) have valvular heart disease, 8 patients (12.6%) had tricuspid regurgitation with pulmonary hypertension, and 20 patients (32.2%) had tricuspid, mitral or aortic regurgitation. The present study indicated that Observation of excess iron in the heart of βTM patients in King Abdulaziz University Hospital (KAUH) through LVEF and serum ferritin analysis have reduced incidence of CHF. LVEF instructs the use of intensive chelation therapy but cannot prevent or predict heart damage or CHF in the course of the disease; this may be due to the poor prognosis once CHF is occurred. More sensitive methods for early detection of cardiac complication arerequired as MRI T2* which is used to estimate myocardial iron and identifies pre-clinical cardiac iron deposition to prevent irreversible cardiac complication.