Cardiac Echography Assessment for Cardiac Iron Overload among Thalassemia Patients: A Cross-sectional Study

Abstract

Background and Objective: Many thalassemia patients don't have any symptoms until the disease has progressed to the point where the heart has been damaged by iron overload. Consequently, the prognosis of such individuals might be improved with early diagnosis of cardiac abnormalities at preclinical levels. We analyzed tissue Doppler echocardiography for its potential use in the preliminary diagnosis of iron overload in these individuals.

Methods: Two- and three-dimensional echocardiography were used to evaluate 52 thalassemic individuals with normal global LV function who were receiving frequent blood transfusions. The echo finding-serum ferritin level correlation was studied.

Results: This study included 52 asymptomatic thalassemic patients (23 females and 29 males) with global LVEF> 55%. They received periodic clinical exams, blood transfusions to maintain hemoglobin levels over 9.5, and chelation treatments (Deferoxamine or combination of Deferoxamine and Deferiprone). Patients averaged 23.75. Serum ferritin averaged 2584 19.3 ng/ml. Spearman's correlation coefficient connected cardio echography and serum ferritin levels. Ecocardiography did not correlate with blood ferritin levels (r = 0.14, p = 0.92). Table 1 details additional linkages. All other echocardiographic markers did not correlate with iron levels, although septal myocardial velocity and global strain did (P = 0.002, P 0.001).

Conclusion: Many thalassemia patients don't show symptoms until iron excess damages the heart. The aforementioned studies and our investigation showed a strong relationship between cardiac echography and iron accumulation. This approach should be tested as a screening tool for myocardial iron excess.